86660720 21573425 pediatric nursing edison o dangkeo rn

8/11/2019 86660720 21573425 Pediatric Nursing Edison O Dangkeo RN

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COMPREHENSIVE LECTURE ON PEDIATRIC NURSING

PART 1. GROWTH AND DEVELOPMENT

GROWTH- in physical size of a structure or whole (Quantitative)

2 PARAMETERS

WEIGHT-most sensitive

Birth weight: 2X by 6 mos

3 by ! yr "X by 2#2$ yrs

LENGTH/HEIGHT

! inch%mo& 'n !st6 mos

$ inch%mo& t #!2 mos

ve& in ht& *uring !styr is +,-

ppro& $ of a*ult ht& at 2 yrs

DEVELOPMENT-in the s.ills or capacity to function (Qualitative)

How to Measue De!e"o#$e%t

by simply observing a chil* *oing speci/c tas.

by noting parent0s *escription of the chil*0s progress

by 11

DDST & Ma'% Rate( Cate)o'es

4anguage 5ersonal#ocial

ine 7otor *aptive

8ross 7otor .ills

MATURATION-synonymous with *evelopment 9 also .nown as ;1'


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PRINCIPLES O0 GROWTH AND DEVELOPMENT!& 8rowth an* *evelopment is a continuous process (from womb to tomb)2&


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mouth# site of grati/cation

ctivity: biting9 suc.ing9 crying (for enFoyment an* release of tension)


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8iving opportunity on short assignments an* proFects

,. I(e%t't5 !s Ro"e Co%6us'o% 812-2* 5s; A(o"es3e%t Pees 4earns who he%she is9 what .in* of person will he%she become by a*Fusting to new bo*y image

;mancipation from parents: liberation%free*om

. I%t'$a35 !s Iso"at'o% 82*-2, 5s; ou%) A(u"t Lo!e 4oo.ing for lifetime partners9 career#focuse*

. Ge%eat'!'t5 !s Sta)%at'o% 82,-&, u# to *-, 5s; M'(("e A(u"t Pae%t'%)

. E)o I%te)'t5 !s Des#a' 8, 5s; Late A(u"t ReJe3t'o%

COGNITIVE THEOR

ea% P'a)et# wiss 5sychologist

1e/nes cognitive acts as ways in which the min* organizes O a*apts to its environment

AL;7# in*ivi*ual0s framewor. of thought

8; J AJ8


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4awrence Rohlberg (!@?") H recognize* the theory of moral *evelopment as consi*ere* to closelyapproimate cognitive stages of *evelopment


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Aooperates in *ressing

4i.es nursery rhymes

CONCERNS@IN0ANTS

COLIC

5aroysmal ab*ominal pain9 common among U 3 mos&

%: 4ou* crying9 ushe* face9 /sts clenche*9 tense* ab*omen

Aauses:

Jverfee*ing wallowing of too much air

7il. formula very high in ALJ

ense* mother *uring breast fee*ing

7anagement:

Burp baby in the mi**le an* after breast fee*ing or every ! oz& of mil. formula

Reep baby in upright position on mother0s chest or shoul*er or in si*e lying position onmother0s arm%lap

CONSTIPATION/DIARRHEA

Aauses:

'naccurate miing of formula

**ing too much sugar


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1 MONTHS

Mal.s well9 runs clumsily an* falls9 Fumps in place9 seats self on a chair

Mal.s up an* *ownstairs hol*ing on to a person0s han* or railing

hrows ball overhea* without falling

Buil*s 3#" bloc.s


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ight time to bring the chil* to the *entist: when temporary teeth are complete (at 3, mos)

TOILET TRAINING

+ C"ues@

Aan stan*9 s=uat an* wal. alone

Aan communicate toilet nee*s

Aan maintain *ryness for an interval of 2 hrs

PRESCHOOL

'*ea about *eath: a form of sleep9 reversible Beginning *evelopment of conscience thru punishment an* rewar*

54: ssociative% Aooperative

B; J: play house9 mo*eling clay9 /nger paints9 *olls9 cars9 *octor0s set

;: Bo*y 7utilation% Aastration fear9 *ar. places9 witches9 ghosts9 thun*er an* lightning

& EARS 80u'ous 0ouKs;

Aatches ball reliably9 throws ball overhea*9 Fumps%s.ips on ! foot

4aces shoes but can0t tie a bow

Aopies a s=uare

1raws 3 bo*y parts to stic. /gure

Nses scissors to cut pictures

Rnows " basic color

Nses !9+,, wor*s but fre=uently *oes not .now meaning

Aannot .eep secrets Quarrelsome9 sel/sh9 impatient9 boasts9 with moo* swings

, EARS 80ustat'%) 0'!eKs;

.ips%hops on alternate feet

hrows an* catches ball

Kumps rope

Aan wal. bac.war*s with heel to toe

Aan tie shoe laces with bow

Aopies triangle

1raws #@ parts of a man

5rints few letters9 numbers an* wor*s such as !stname

Las imaginary playmate

Nses 29!,, wor*s9 as.s meaning of wor*s

Aan .eep secrets

CHARACTER TRAITS@ PRESCHOOL

Aurious (CMLD)9 creative9 imaginative9 imitative

5arents must live by eample not to cause confusion to the chil*

'1;


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pen* time with the chil*9 orient chil* to the new environment

7a.e chil* secure

OTHER 0EARS@1isplacement from school9 loss of privacy9 *eath

I(ea a:out (eat@(#@ yrs) permanent loss of corporal life

SIGNI0ICANT OTHERS@ teacher an* peers of same se

SIGNI0ICANT DEVELOPMENT

prone to greenstic. fractures

have a mature vision

EARS

Boys an* girls are of same height

ear of constant motion% Alumsy movements

Aan ri*e a bicycle

emporary teeth begins to fall9 permanent teeth begins to appear (!stmolars)

1e/nes wor*s by their use

ecognizes all shapes

Begins to interact with 8o*

eacher: authority /gure


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8irls: !,#!2 yrs

Boys: !2#!" yrs

CHARACTER TRAITS@ SCHOOL AGE

'n*ustrious

4oves to collect obFects

ees self in the eyes of the teacher an* classmates

Aompares abilities an* achievements with peers

PEER GROUPS tea3es@ o see oneself thru the eyes of others

Low to be a lea*er an* a follower

Mhen to be assertive an* to yiel*

8roup loyalty

Aonformity to group stan*ar*s

Low to be a goo* sport

Low to accept an* carry out responsibilities

Aooperation

'n*epen*ence from a*ults

EHAVIOR PROLEMS

Aan0t bear to lose they will cheat9 lie an* steal easons for cheating

'mitating a*ults

1epen*s on practicality of the situation

easons for lying

Aonfusion in chil*0s cognitive abilities an* egocentrism

'nability to separate ma.e believe%fantasy from reality

ailure to come up with epectations

easons for stealing

Aonfusion over perceive* ownership

'mpulse of peer pressure

C8etting bac.D on embarrassing parents

CONCERNS@ SCHOOL AGE

Sa6et5 7otor vehicular acci*ents

1rowning

Jpen ame burns

Nut't'o%

on*ness for Fun. foo*s

.ipping meals% eating in school

Jbesity

each nutrient value of foo*

Aontrol of sale of Fun. foo*s

5ac.e* snac.s%lunch

5revention of obesity

Meight re*uction program

Alose weight monitoring

Se E(u3at'o% o%@

7enstruation an* repro*uctive organ function

econ*ary se characteristics *evelopment

7oral an* social implication of seual maturity

SIGNS O0 SEUAL MATURIT

8'4 BJ

'ncrease in size of breasts (helarche#!stsign) an*genitalia (until !? yrs)

ppearance of aillary an* pubic hair (*renarche)

Mi*ening of hips 1eepening of voiceppearance of aillary an* pubic hair 1evelopment of muscles

7enarche#last sign 'ncrease in size of testes an* penis# !stsign (until !


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yrs)

5ro*uction of viable sperm# last sign (nocturnalemission by ! yrs)

ADOLESCENT

ge of transition from chil*hoo* to a*ulthoo*

0EARS@obesity9 acne9 *eath9 homoseuality9 replacement from frien*s

SIGNI0ICANT OTHERS@peers of opposite se

SIGNI0ICANT DEVELOPMENT@

Aonict between own nee*s of seual satisfaction an* societal epectations

Aore concern: change of image an* acceptance of opposite se

1istinct o*or: *ue to stimulation of pocrine glan*s

PERSONALIT TRAITS

'*ealistic9 rebellious9 reformers9 conscious with bo*y imageCONCERNS

7otor vehicular acci*ents

7asturbation: causes conict with morality

5eer 5ressure: smo.ing9 alcoholism9 *rug a**iction9 premarital se

Bo*y image: eating *isor*ers aEecting nutritional state

noreia nervosa

Bulimia (Binge#eating)

PART 2. IMMEDIATE CARE 0OR THE NEWORN

PRIORITIES O0 THE NEWORN IN THE 0IRST DAS O0 LI0E!& 'nitiation an* maintenance of respiration2& ;stablishment of etrauterine circulation3& Aontrol of bo*y temperature"& 'nta.e of a*e=uate nourishment+& ;stablishment of waste elimination6& 5revention of infection& ;stablishment of infant#parent relationship?& 1evelopmental care that balances rest an* stimulation for mental *evelopment

INITIATION AND MAINTENANCE O0 RESPIRATION


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;J#54A;


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5rematurity: poi.ilothermic (col* bloo*e*)# easily a*apt to of envt *ue to immaturethermoregulating system (Lypothalamus)

hin s.in an* Q fats 'nability to shiver Born wet

5rocess of Leat 4oss

!& ;vaporation# from bo*y to air2& Aon*uction# from bo*y to col*9 soli* obFect

3& Aonvection# from bo*y to cooler9 surroun*ing air"& a*iation# from bo*y to a col*9 soli* obFect not in contact with the bo*y

;Eects of Lypothermia (Aol* tress)

;arliest sign: L

!& Lypoglycemia# *ue to glucose utilizationglucose to the brain A5 (irreversible brain *amage)2& 7etabolic aci*osis# *ue to catabolism of brown fat or brown a*ipose tissue (best insulator of


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Aauses:

'mproper breast emptying

Nnhealthy seual practices

'mproper hygiene

7anagement:

7anually epress infecte* breast but *on0t fee* this mil. to the baby

a.e antibiotics as or*ere* an* continue breast fee*ing

CONTRAINDICATIONS IN REAST 0EEDING

7aternal Aon*itions Luman 'mmuno*e/ciency Pirus (L'P)

Aytomegalovirus (A7P)

Lepatitis B virus (LBP)

ta.ing Marfarin (Aouma*in)


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5hysiologic Meight 4oss: +#!+- of birth weight *uring the ! stw. of life r%t voi*ing an* limite*

inta.e

PART ,-A. PHSICAL EAMINATION AND DEVIATION 0ROM THE NORMALIMPORTANT CONSIDERATIONS DURING PHSICAL EAMINATION

]


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] amilial] ;posure to ubella (8erman 7easles): *angerous *uring the !st mo& (fetal heart is *eveloping at

"#? w.s J8)] ailure of the heart structure to progress

] 8eneral igns O ymptoms] A

] Mea.9 mu^e*9 lou*9 breathless] A'P' 4;P;4

] estless9 lethargic] Nnresponsive to pain

] 5JN'


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] 5ulmonary Bloo* lowH Pentricular eptal 1efect (P1)H trial eptal 1efect (1)H ;n*ocar*ial Aushion 1efect (P canal)H 5atent 1uctus rteriosus (51)

VENTRICULAR SEPTAL DE0ECT] 7ost common AL1] bnormal opening between 2 ventricles (size: pinpoint to (#) septum)] igns an* ymptoms

] ystolic murmur at lower sternal bor*er an* no other signi/cant 9 may have % of AL*epen*ing on size of *efect

] ;A8%AX: 9 P hypertrophy] Aar*iac cath: saJ2 at 9 P

] 7anagement

] 5alliative: 5ulmonary rtery (5) Ban*ing# to pulmonary bloo* ow] Aorrective: Jpen Leart urgery with car*iopulmonary (A5) bypass: P1 patch closure (using

1acron patch)

ATRIAL SEPTAL DE0ECT] 5atent oramen Jvale] bnormal opening between 2 atria] igns an* ymptoms

] ystolic murmur at upper sternal bor*er an* no other signi/cant I may have % of AL beforeschool age

] ;A8%AX: 9 P hypertrophy] Aar*iac cath: saJ2 at 9 P

] 7anagement

] 5alliative: 5 Ban*ing# to pulmonary bloo* ow] Aorrective: Jpen Leart urgery with car*iopulmonary (A5) bypass: 1 patch closure (using

1acron patch)

ENDOCARDIAL CUSHION DE0ECTS] Jr trioventricular (P) canal

H ssociate* with 1own0s yn*romeH ll chambers communicateH Mith low 1 an* high P1

] igns an* ymptomsH 7o*erate to severe ALH 7il* cyanosis when cryingH (T) murmurH Aar*iac cath con/rms the *

] 7anagement

H 5alliative: 5 Ban*ing# to pulmonary bloo* owH Aorrective: Jpen Leart urgery with car*iopulmonary (A5) bypass

] 5atch closure

] P valves reconstruction] 7itral valve replacement (with severe *efect)

] A post#op: AL9 mitral regurgitation9 arrythmia9 pulmonary L NODULESH are9 small (,&+#! cm)9 non#ten*er swellings that persists in*e/nitely after *isease onset an*gra*ually resolve without resulting *amage

H oun* over Foints] ,. SDENHAM CHOREA/ ST. VITUS DANCE

H 'nvoluntary9 purposeless movts of etremities accompanie* with facial grimacing9 speech*isturbance9 emotional lability an* muscle wea.ness

H ;aggerate* with aniety an* relieve* with sleep] . ASCHO00 ODIES

H 'nammatory9 hemorrhagic9 bullous lesions causing swelling9 fragmentation an* alterations inconnective tissues

H oun* in heart (mitral valve)9 bloo* vessels9 brain9 serous surfaces of Foints an* pleura

RHD@ MINOR SIGNS AND SMPTOMS


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] upraclavicular] uprasternal] 'ntercostal] ubsternal] ubcostal] Xiphoi*

] 7anagement] ;levate hea*9 with nec. slightly eten*e* (Jpen airway)] 5roper suctioning (Alear airway)] J2 a*ministration with humi*ity (lowest J2 concentration possible)] 5lace on A55% 5;;5 to maintain alveoli partially open (to prevent collapse)] 7onitor P9 s.in color an* B8] Ahest physiotherapy

] 5ercussion: use pa**e* small plastic cup or small J2 mas.] Pibration: use pa**e* electric toothbrush

] *minister surfactant replacement therapy via intratracheal route] 'nstill thru catheter inserte* into ;] voi* suctioning for at least 2 hours after

] MJ L an* *esaturation

LARNGOTRACHEORONCHITIS] 7ost common form of croup] 1ue to viral or bacterial infection] 8ra*ual onset9 may be prece*e* by N'] igns an* ymptoms

] ever

] 'rritability an* restlessness] noreia9


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] *minister me*s as or*ere*:] nti#viral: ibavirin (Pirazole) via aerosol by hoo*9 tent9 mas. or ventilator tubings] P 'g'P (espi8am) or palivizumab (ynagis)

EPIGLOTTITIS] ;mergency of all N'] A of bronchiolitis] Bacterial form of croup (& pneumoniae or L& inuenzae type B)] u**en%acute onset9 usually in winter] Aommon among 2#+ years of age] igns an* ymptoms

] Ligh fever] ore9 re*9 iname* throat] (#) cough] 1rooling] 1ysphagia] 7u^e* voice] 'nspiratory stri*or] gitation

] Alassic ign] ripo* 5osition: leaning forwar* with tongue protrusion

] 7anagement] voi* tongue *epressor9 oral thermometer9 laryngoscopy9 throat swab] 5repare trache set not ; set] 5lace pt insi*e cool 7ist tent or Aroupette with high humi*i/cation (to re*uce airway swelling)] 8ive plastic9 washable toys

]


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H (#) breath soun*s with tachypnea: ventilatory failure an* asphyia] 7anagement

H ;liminate allergensH voi* etremes of an* eposure to viral respiratory infectionH ecognize early of an asthma attac.H *e=uate rest9 sleep9 well#balance* *iet9 ui* inta.e9 eerciseH nnual u vaccineH Ahest physiotherapyH Nse of nebulizer9 meter#*ose inhaler9 cleaning of *evices (to prevent oral can*i*iasis)H *minister me*s as or*ere*

] Broncho*ilators

] 2 agonist (albutamol9 lbuterol)] acemic epinephrine

] Aorticosteroi*s] ntiallergic me*s] UAMATION] peeling of the


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] iron *iet (*ar.9 green leafy vegies9 brea*s9 cereals9 egg yol.9 .i*ney beans9 liver9 meat9 raisins)] *minister iron supplements as or*ere*

] 'n between meals] Mith Pit& A%citrus Fuice: absorption

] 7il.%antaci*s: absorption] 4i=ui* iron: a.en with straw or me*icine *ropper at the bac. of mouth] %;: foul aftertaste9 melena9 constipation

HEMOPHILIA

] X#lin.e* recessive] 3 ypesH Lemophilia : *e/cient clotting actor P''' (classic)H Lemophilia B: *e/cient clotting actor 'X (Ahristmas *isease)H Lemophilia A: *e/cient clotting actor X'

S')%s a%( S5$#to$s] u**en bruising when chil* grows (earliest sign)

H 1elaye* *iagnosis at birth because


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H 8iven to h(#) mother9


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] 7onitor 'OJH Best: weigh the babyH Meigh the *iaper: !g> !cc

] 7onitor P] voi* lotion or oil to s.in (to prevent burns)] ;pect bright green urine O stool (loose)] ransient %;: bronze baby syn*rome

] b< bloo* glucoseH 3,mg%*l in !st 2hrs or

H "+mg%*l after !st 3 *ays of life] < bloo* glucose:H ",#6,mg%*l: ! *ay#ol*H +,#@,mg%*l: ! *ay#ol*

] %: 9 twitching9 tremors9 cyanosis9 unstable 9 lethargy9 poor muscle tone] 7gt: early fee*ings (po or 'P as or*ere*)

HEAD _ (2+-) the entire bo*y length

tructures

utures: sagittal9 coronal9 lamb*oi*al

ontanels: 69 2 are palpable (nterior an* 5osterior)

A%te'o 0o%ta%e" 8e)$a; 1iamon*#shape*

3X" cm9 closes at !2#!? mos

Y + cm: hy*rocephalus 5remature closure: Araniostenosis or Araniosynostosis

mall9 slow growing brain: 7icrocephaly

(#) cerebral hemisphere: vencephaly

Poste'o 0o%ta%e" 8La$:(a; riangular shape

!X! cm

Aloses at 2#3 mos

STRUCTURES O0 THE HEADCRANIOTAES

4ocalize* softening of the cranial bones among


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'solation for at least 2"hrs after antibiotics are initiate*

*minister antibiotic as or*ere*

7onitor neuro P9 '%J9 nutritional status

1etermine chil*0s close contacts for prophylactic treatment

SENSES Se%se o6 S')t 8E5es;

clera


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ense of Learing (;ars)

bnormal /n*ing: (T) yellowish9 foul#smelling *ischarge

OTITIS MEDIA@infection of mi**le ear

5re*isposing actors horter9 wi*e9 straight an* narrow ;ustachian tube in chil*ren

Bottle propping

Aleft lip an*%or palate

S')%s a%( S5$#to$s@

7il.y9 purulent foul#smelling *ischarge

5ain on pulling pinna

% of N': cough9 col*s9 fever

Jtoscopic eam: re*9 opa=ue9 bulging tympanic membrane9 (#) light ree

Ma%a)e$e%t@

ui* inta.e9 fee* chil* in upright position9 avoi* chewing gums to pain pply local heat

i*e#lying position on aEecte* si*e to *rain *ischarges

Alean *ischarges with sterile cotton swabs

*minister me*s as or*ere*:

ntipyretic for fever

ntibiotics for !,#!" *ays: moicillin9 mpicillin (A: Bacterial meningitis)

;ar *rops

Learing loss screening is important

urgery: 7yringotomy with ympanostomy tube insertion

o e=ualize pressure an* to .eep the ear aerate*

7aintaine* until the tubes fall oE or after 6 mos& to prevent permanent hearing loss

5t shoul* .eep ear *ry9 wear earplugs *urign bathing9 shampooing an* swimmingI avoi*

*iving an* submerging un*er water

MOUTH AND TONGUE 7outh: symmetrical9 opens evenly when crying

ongue: appears large9 symmetrical

oft an* har* palates intact

Nvula in mi*line

TONSILLITIS ADENOIDITIS 'nammation or infection of tonsils an* a*enoi*s

igns O ymptoms

ecurrent sore throat (cough9 fever)

;nlarge*9 bright re* tonsils with white eu*ate

1iWculty swallowing

7outh breathingI unpleasant mouth o*or

;nlarge* a*enoi*s: nasal speech9 *iWculty hearing9 snoring or obstructive sleep apnea

PRE-OP MANAGEMENT ssess for signs of

ctive infection

Blee*ing (chec. clotting stu*ies) because the throat is vascular

4oose teeth to prevent aspiration

5rone or si*e#lying position

1on0t suction unless there is airway obstruction

MJ hemorrhage (fre=uent swallowing)

voi* coughing or clearing of throat 8ive clear9 cool noncitrus9 noncarbonate* *rin.s9 avoi* re* li=ui*s (mas.s blee*ing) an* mil.

(covers throat) voi* using straw9 for. or sharp obFects

5ain me*s as or*ere*

ELLKS PALS acial


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Ahil* appears normal but signs of inammation may be presenthree 5hases cute: all % appears9 T restlessness for 2 months (hallmar. of R1) an* arthritis ubacute: resolution of all %9 at greatest ris. of coronary artery aneurysms (bloo* vessels

stretch " w.s post onset) an* coronary thrombosis (*ue to thrombocytosis an*hypercoagulability)

Aonvalescent: bloo* values return to < (6#? w.s post onset) e&g& ;9 thrombocytosis

Ma%a)e$e%t 7onitor fre=uently Leart soun*s O rhythm ;tremities for e*ema9 re*ness O *es=uamation ;yes O mucous membranes for inammation 1ietary O ui* inta.e Meight J1

5assive J7 eercises to facilitate Foint movement 8ive soft foo*s%li=ui*s (not too hot or too col*) *minister as or*ere*

Ligh *ose 'P 'mmunoglobulin *uring the !st !, *ays: 2g%.g as !,#!2 hr *rip (to inci*ence ofcoronary artery lesions O aneurysms)

%;: allergic rn9 etravasation9 pro*uction of antibo*ies (*elay 77 vaccine !! mos& an*chic.enpo vaccine + mos after 'P'8)

spirin

Ligh *ose: ?,#!,,mg%.g%*ay (in *ivi*e* *ose =6h) antipyretic an* antiinammatory (%;toicity: tinnitus9 L9 *izziness9 confusion)

4ow *ose: 3#+mg%.g%*ay antiplatelet (%; easy bruisingavoi* contact sports) Marfarin (Aouma*in) for chil*ren with giant aneurysm (Y? mm)

CLE0T LIP CLE0T PALATE Aongenital anomaly ailure of the soft tissue or bony structure to fuse *uring embryonic *evelopment Aausative factors

8enetic9 Lere*itary9 ;nvironmental9 a*iation9 ubella virus9 eratogensCLE0T LIP

ailure of the me*ian maillary nasal processes to fuse by +#? w.s of pregnancy Aan be unilateral or bilateral Aommon in boys urgery: Aheiloplasty

*one as early as !#3 mos not to remove suc.ing reeCLE0T PALATE

ailure of the palate to fuse

Aommon in girls

Su)e5@Nraroplasty

*one as early as "#6 or !2#!? mos to allow normal palatal growth O not to impair speech

Ma%a)e$e%t ;motional support


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SUPPLEMENTAL 0EEDING 5rinciples

oli* foo* are oEere* accor*ing to the following se=uence: cereals (given as early as " mos: start

of iron catabolism9 usually given at 6 mos: iron catabolism is complete)fruits vegies meat/nger foo*s table foo*s

Begin with small amount

inger foo*s are oEere* by 6 mos

1ilute citrus Fuices oEere* by 6 mos

JEer new foo* one at a time9 with interval of "# *ays (to *etermine foo* allergy)

oft table foo* (mo*i/e* family menu) oEere* by !2 mos (baby in high chair) voi* giving half#coo.e* egg almonellosis voi* giving honey 'nfant Botulism

0LUID AND ELECTROLTE/ ACID-ASE ALANCE 1epen*ent on the following:

chemical buEers

renal an* respiratory system involvement

*ilution of strong aci*s an* bases in bloo*

ACID-ASE IMALANCE Res#'ato5 a3'(os's

Lypoventilation con*itions

pnea

Aystic /brosis (AJ2%air trapping)

Res#'ato5 a"4a"os's

Lyperventilation con*itions

achypnea: asthma9 1

Meta:o"'3 a3'(os's

Ahronic *iarrhea

evere hypothermia:


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Ma%a)e$e%t

1iet9 stool softeners9 *aily rectal irrigation with p


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ntaci*s (7aalo)# to neutralize gastric aci* between fee*ings

Su)e5@


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pecimen: urine

5reparation: ALJ< inta.e9 3#" *ays post breast fee*ing (to allow phenylalanine buil*#up)

5henisti est

pecimen: urine T erric Ahlori*e

(T) greenish spots at *iaper

Ma%a)e$e%t@avoi* neurologic *amage

5henylalanine *iet in*e/nitely


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Nnless the poison was corrosive9 caustic (strong al.ali such as 4;) or a hy*rocarbon9 vomiting is

the most eEective way to remove the poison from the bo*y

5rinciples

yrup of 'pecac# oral emetic to cause vomiting after *rug over *ose or poisoning

!+ ml to a*olescent9 school age an* pre#school

!, ml to infant

Aan give up to 2n* *ose if *on0t vomit after !st *ose

Nniversal anti*ote # charcoal9 mil. of magnesia9 an* burne* toast


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Bruises: i*entical (e&g& cigarette butts)9 of *iEerent stages

eport within "? hrs

Reep chil* in safe environment


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or immobilization 7aintains bone alignment 5revents muscle spasm

Mate'a"s 8ypsum (AaJ" crystals) toc.inette: prevents irritation 4ea* pencil: to mar. area Basin of water

Marm: slows setting process

Aol*: hastens setting processNus'%) Cae P'o't5@


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+. 5a%tKs ta3t'o% Both legs raise* @, angle to be* Nse* for chil*ren un*er 3 years an* 3, lbs to treat fractures of the femur an* hip *islocation Buttoc.s must be slightly oE mattress Rnees slightly ee*

+. Pe"!'3 ta3t'o% 5elvic gir*le with etension straps attache* to ropes an* weights use* for low bac. to re*uce muscle spasm an* maintain alignment

S4e"eta" Ta3t'o% raction applie* *irectly to the bones using pins9 wires9 or tongs (Arutch/el*) that are surgically inserte*9

use* for fractures femur9 tibia9 humerus9 cervical spine

1. a"a%3e( Sus#e%s'o% Ta3t'o% 5ro*uce* by a counterforce other than the patient0s weight ;tremity oats or balances in the traction apparatus 5atient may change position without *isturbing the line of traction Nse* for *isplace* or overri*ing f of femur elieves muscle spasms ealigns f fragments 5romotes callus formation

COMMUNICALE DISEASESMEASLES 8RUEOLA;

A)e%t@ Paa$5o!'us

I%3u:at'o% #e'o(@!,#2, *ays

Aommunicable perio*: "*ays before to +*ays after rash appears

ource: respiratory tract secretions9 bloo*9 urine

7J: airborne9 *irect contact with *roplets

S')%s a%( S5$#to$s ever9 malaise9 cough

timson0s eye (conFunctivitis)9 puEy eyeli*s9 mucopurulent *%c9 photophobia

tomatitis

7aculopapular rash begins at behin* ears sprea*s *own to feet9 *ries O peels oE

Ropli. spots: small9 re* spots with bluish white center at oral mucosa X3*ays

Ma%a)e$e%t espiratory isolation9 Be* rest

Aool mist vaporizer for cough ;ye care9 1im lights for photophobia

;ar care9 MJ otitis me*ia

Jral care9


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A)e%t@ Paa$5o!'us

I%3u:at'o% #e'o(@!"#2! *ays

Aommunicable perio*: imme*iately before O after swelling begins

ource: saliva9 urine

7J: *irect contact with *roplets

S')%s a%( S5$#to$s ever9 L9 malaise

noreia

;arache esp& when chewing

5aroti* glan* swelling Jrchitis

Ma%a)e$e%t espiratory isolation9 be*rest

voi* foo* that re=uire chewing

Lot or col* compress at nec.

o relieve orchitis9 apply warmth O local support with tight#/tting un*erpants

CHICFENPO 8VARICELLA; A)e%t@ Va'3e""a-oste !'us

I%3u:at'o% #e'o(@!3#! *ays

Aommunicable perio*: !#2*ays before O up to 6*ays after crusting begins

ource: respiratory tract secretions9 s.in lesions


S')%s a%( S5$#to$s 4ow gra*e fever9 malaise

7aculopustular rash becoming crusts9 begins on trun. an* scalp an* sprea*s to etremities

Ma%a)e$e%t Aontact an* irborne isolation

t home9 isolate chil* until vesicles have *rie*

upportive care

PERTUSSIS 8WHOOPING COUGH; A)e%t@ o(ete""a #etuss's

I%3u:at'o% #e'o(@+#2! *ays (usually !, *ays)

Aommunicable perio*: *uring catarrhal stage

ource: respiratory tract secretions


S')%s a%( S5$#to$s

espiratory infection followe* by severity of coughMa%a)e$e%t espiratory isolation

voi* *ust9 smo.e O su**en change in

;ncourage ui* inta.e

*minister as or*ere*

J2 tent with high humi*ity

ntibiotics

5ertussis 'g

DIPHTHERIA gent: Aorynebacterium *iphtheriae

'ncubation perio*: 2#+ *ays

Aommunicable perio*: after 3 (#) cultures9 usually 2#" wee.s

ource: nasopharyngeal secretions

7J: *irect contact

S')%s a%( S5$#to$s 4ow gra*e fever9 malaise9 sore throat

oul#smelling9 mucopurulent nasal *%c

8ray membrane on tonsils O pharyn

4ympha*enitis (nec. e*ema)

Ma%a)e$e%t Aontact isolation

Be* rest

*minister as or*ere*

ntibiotics

ntitoin after s.in test to r%o sensitivity to horse serum

TETANUS 8LOCFAW/TRISMUS;


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A)e%t@ C"ost'('u$ teta%' 8a%aeo:'3 %o%-$ot'"e s#oe 6o$'%);

Pegetative9 active form releases

etanolysin# BA hemolysis

etanospasmin# tonic type of seizures

ource: soil9 gut of herbivorous animals

7J: *irect contact


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86660720 21573425 pediatric nursing edison o dangkeo rn

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