Maternal Child
Acute and infectious respiratory illnesses:
Croup effects under the age of 5 - bark cough - comfort, treat fever, fluids,
corticosteroids and nebulae treatments if needed, humid environments
Signs of respiratory distress - dyspnea - rapid breathing
Infectious mononucleosis (not on take home test)
sore throat, swelling of lymph nodes, rash on trunk, effects young adults, mild
analgesics, ampicillin or amoxicillin, throat licensers, corticosteroids for respiratory
distress
May be up to 3 months before adolescent recovers
Otitis Media - room temp fluid, around 5 to 6 years of age under 3 down and back.
Prevalent in houses of smoke or large family. Clinical manifestations: middle ear pain
and inflammation - acute AOM; fever and otalgia (ear pain) Not always treated with
antibiotics, depends on age. NOTHING can go in the ear, wipe out the drainage do not
put q-tip
Bronchiolitis- most common infection in the first 24 months- RSV most common
causative agent. Transmission by direct contact
Clinical - supplemental oxygen, bed rest
Acute Epiglottitis - life threatening supraglottic obstruction inflammation, sitting in a
tripod position, be ready to intubate, do not stick a tongue blade, usually bacterial -
treated with antibiotics, and corticosteroids
Prophylactic antibiotics for household members and contacts
Can be caused by smoke inhalation or crack cocaine,
Respiratory emergency - monitor breathing
Indications of respiratory failure - dyspnea, tripod position, cool clammy skin, cyanosis,
retractions, use of neck muscles, mental status alterations, restlessness, anxiety,
tachycardia, stridor, grunting respirations, intercostal retractions - fighting for
respirations
Cardiopulmonary resuscitation - 1 rescue breath 30:2 - 2 rescue breaths (15:2) CAB;
100 compressions per minute
Fluids - in infants extracellular fluid (ECF) makes up one half of total body water - within
1 year, in toddlers ECF compartment accounts for 1/3 of fluid
, – vomit and diarrhea lose fluids quickly; input must = output
– when treating acute diarrhea and dehydration - do not stick IV if can be avoided, try
oral hydration first, if severe then IV
– Spread gastroenteritis through poor hand hygiene
– Severe dehydration common cause of acute renal failure in children
– Types of dehydration dictate how to replace fluids (isotonic, hypotonic, hypertonic)
– signs of fluid overload - moist lungs, bonding pulse
Diarrhea - leading cause of death in children under age 5 years throughout the world
– history taking is so important: acute, how long? food? viruses? anyone sick?
– Assessment - inspect first
Constipation:
– Encopresis - constipation with fecal soiling after being toilet stained: be able to
openly discuss their issues
Hirschsprung Disease (megacolon)
– absence of parasympathetic ganglion cells in portion of large intestine, bowel
enlargement proximal to defect, length of involved bowel varies from internal
sphincter to entire colon
– these children can’t poop
– may require surgical treatment
– postop nursing care based on type of surgery performs
– keep operative site clean and dry
– monitor for pain
– provide skin protection, patient and family education
Vomiting:
– dehydration
– tetany; seizures from severe alkalosis
– metabolic alkalosis from loss of hydrogen ions
– electrolyte imbalance
Signs of dehydration ; sunken eye balls, tenting skin, lethargic,
hydrate with oral and then IV if severe, rest after feeding, side lying/low fowlers position,
thicken liquids, small volume feedings q2-3 hrs monitor I/O’s
GERD
– Limit fatty foods, which dealt gastric emptying
– avoid foods that decreases LES
– Chewing gum because is stimulates production of bicarbonate-containing saliva,
which neutralizes acid
– Avoid eating or drinking 2 -3 hours before bedtime; avoid over eating
Crohn Disease - ulceration of intestinal submucosa accompanied by congestion
– electrolyte imbalance
– lymph nodes enlarged
Acute and infectious respiratory illnesses:
Croup effects under the age of 5 - bark cough - comfort, treat fever, fluids,
corticosteroids and nebulae treatments if needed, humid environments
Signs of respiratory distress - dyspnea - rapid breathing
Infectious mononucleosis (not on take home test)
sore throat, swelling of lymph nodes, rash on trunk, effects young adults, mild
analgesics, ampicillin or amoxicillin, throat licensers, corticosteroids for respiratory
distress
May be up to 3 months before adolescent recovers
Otitis Media - room temp fluid, around 5 to 6 years of age under 3 down and back.
Prevalent in houses of smoke or large family. Clinical manifestations: middle ear pain
and inflammation - acute AOM; fever and otalgia (ear pain) Not always treated with
antibiotics, depends on age. NOTHING can go in the ear, wipe out the drainage do not
put q-tip
Bronchiolitis- most common infection in the first 24 months- RSV most common
causative agent. Transmission by direct contact
Clinical - supplemental oxygen, bed rest
Acute Epiglottitis - life threatening supraglottic obstruction inflammation, sitting in a
tripod position, be ready to intubate, do not stick a tongue blade, usually bacterial -
treated with antibiotics, and corticosteroids
Prophylactic antibiotics for household members and contacts
Can be caused by smoke inhalation or crack cocaine,
Respiratory emergency - monitor breathing
Indications of respiratory failure - dyspnea, tripod position, cool clammy skin, cyanosis,
retractions, use of neck muscles, mental status alterations, restlessness, anxiety,
tachycardia, stridor, grunting respirations, intercostal retractions - fighting for
respirations
Cardiopulmonary resuscitation - 1 rescue breath 30:2 - 2 rescue breaths (15:2) CAB;
100 compressions per minute
Fluids - in infants extracellular fluid (ECF) makes up one half of total body water - within
1 year, in toddlers ECF compartment accounts for 1/3 of fluid
, – vomit and diarrhea lose fluids quickly; input must = output
– when treating acute diarrhea and dehydration - do not stick IV if can be avoided, try
oral hydration first, if severe then IV
– Spread gastroenteritis through poor hand hygiene
– Severe dehydration common cause of acute renal failure in children
– Types of dehydration dictate how to replace fluids (isotonic, hypotonic, hypertonic)
– signs of fluid overload - moist lungs, bonding pulse
Diarrhea - leading cause of death in children under age 5 years throughout the world
– history taking is so important: acute, how long? food? viruses? anyone sick?
– Assessment - inspect first
Constipation:
– Encopresis - constipation with fecal soiling after being toilet stained: be able to
openly discuss their issues
Hirschsprung Disease (megacolon)
– absence of parasympathetic ganglion cells in portion of large intestine, bowel
enlargement proximal to defect, length of involved bowel varies from internal
sphincter to entire colon
– these children can’t poop
– may require surgical treatment
– postop nursing care based on type of surgery performs
– keep operative site clean and dry
– monitor for pain
– provide skin protection, patient and family education
Vomiting:
– dehydration
– tetany; seizures from severe alkalosis
– metabolic alkalosis from loss of hydrogen ions
– electrolyte imbalance
Signs of dehydration ; sunken eye balls, tenting skin, lethargic,
hydrate with oral and then IV if severe, rest after feeding, side lying/low fowlers position,
thicken liquids, small volume feedings q2-3 hrs monitor I/O’s
GERD
– Limit fatty foods, which dealt gastric emptying
– avoid foods that decreases LES
– Chewing gum because is stimulates production of bicarbonate-containing saliva,
which neutralizes acid
– Avoid eating or drinking 2 -3 hours before bedtime; avoid over eating
Crohn Disease - ulceration of intestinal submucosa accompanied by congestion
– electrolyte imbalance
– lymph nodes enlarged
