CAPA REVIEW #1
What are pediatric otolaryngology patients considerations for surgery? -
ANS-•Preprocedure> fear of separation, pain, injury, & death. establish trust reassure,
child fears 'loss of control'> allow child to
choose scent for induction anxiety>prepare child +parents, support parent-present
induction if allowed
•intaprocedure>airway * ^ risk of laryngospasm & vomiting if induced with crying
maintain body temp > kids lose heat faster than adults
Define tympanoplasty (myringoplasty) and care of patient concerns - ANS--procedure
used to improve hearing
-hearing deficit may be present preop. allow pt. to wear hearing aids to DR. hearing may
be worse p/o due to packing/dressing > warm pt.
-monitor facial nerve
-Phase I-HOB ^30° to minimize Eustachian tube edema>clarify with surgeon. position
with operative ear upward to avoid pressure. treat nausea/vomiting & vertigo. avoid
excess motion. transfer slowly
-Phase II-teaching>no wet ears, slow moving, sneeze, with mouth open, popping ears is
normal
D/C instructions of patient with Septoplasty - ANS--change mustache dressing PRN.
maintain count + frequency of saturated
-use humidifier except nausealtarry stools
-avoid nose blowing;stiff secretions to throat & swallow or spit out
-avoid bending, straining or lifting
-sneeze with mouth open
-avoid straws or nasal packing used
1) C1-C4 injury
2) C5 injury involves: - ANS-1-quadriplegia-complete loss of
motor, sensory functions from neck down-including respiratory
2-quadriplegia-loss of all functions decreased upper shoulder level. phrenic nerve intact,
but not intercostal muscles
1) C6 injury
2) C7 injury
3) C8 injury involves: - ANS-1) quadriplegia-loss of function decreased shoulders &
upper arms. no use of intercostal muscles
, 2) incomplete quad loss of motor control to parts of arm & hand. loss of sensation
decreased clavicle & parts of arm/hand. 0 intercostals
3) incomplete quad 0 motor to parts of hand/arm. 0 sensation deceased chest/part of
hand. 0 intercostal
1) T1-T6 injury
2) T6-T12 injury
3)L1-L4 injury involves: - ANS-1. paraplegia. 0 motor function decreased mid chest,
including trunk muscles. 0 sensation from mid chest decreased, including lower limbs,
phrenic nerve functions independently some use of intercostal
2) paraplegia. 0 motor control/sensation decreased waist. 0 interference on respirations
3) paraplegia. loss of motor most of legs/pelvic area. 0 sensation to lower abd/legs
1) L3-L4 injury
2) L4-Sz injury involves: - ANS-1) incomplete para. 0 control/function or part of lower
legs/ankles/feet
2. incomplete paraplegia varying degrees of loss can walk with braces. may use
wheelchair & can be pretty independent
Signs of autonomic hyperretlecia : - ANS--paraxysmal ^BP, headache, vasodilation,
flushing, sweating, goosebumps ^ with SCI
-also spasticity of muscles & orthostatic hypotension possible
myasthenca gravis patient concerns: - ANS--chronic, progressive, causes voluntary
weakness
-improvement with rest/anticholinesterasemeds
-myasthenia crisis can be from exacerbation or too much anticholinesterase meds >
real. difficulty wracking in muscles including muscles in throat
-meds & pyndostigmin, heostigmin can be reversed by many anesthesia meds
-watch for real. distress aspiration, difficulty talking/swallowing auscultate lungs, SPO2
-^risk of infection
Caring for autistic patient - ANS--do not insist on eye contact. provide language tools-
-get info from caregiver about likes/dislikes, skills & abilities
-determine it from vitamins/what food has been cut from diet
infancy development and lifespan care - ANS--oral stage (freud)
-trust vs. mistrust (erickson)
-sensorimotor period (piagets)
-birth-12 months
What are pediatric otolaryngology patients considerations for surgery? -
ANS-•Preprocedure> fear of separation, pain, injury, & death. establish trust reassure,
child fears 'loss of control'> allow child to
choose scent for induction anxiety>prepare child +parents, support parent-present
induction if allowed
•intaprocedure>airway * ^ risk of laryngospasm & vomiting if induced with crying
maintain body temp > kids lose heat faster than adults
Define tympanoplasty (myringoplasty) and care of patient concerns - ANS--procedure
used to improve hearing
-hearing deficit may be present preop. allow pt. to wear hearing aids to DR. hearing may
be worse p/o due to packing/dressing > warm pt.
-monitor facial nerve
-Phase I-HOB ^30° to minimize Eustachian tube edema>clarify with surgeon. position
with operative ear upward to avoid pressure. treat nausea/vomiting & vertigo. avoid
excess motion. transfer slowly
-Phase II-teaching>no wet ears, slow moving, sneeze, with mouth open, popping ears is
normal
D/C instructions of patient with Septoplasty - ANS--change mustache dressing PRN.
maintain count + frequency of saturated
-use humidifier except nausealtarry stools
-avoid nose blowing;stiff secretions to throat & swallow or spit out
-avoid bending, straining or lifting
-sneeze with mouth open
-avoid straws or nasal packing used
1) C1-C4 injury
2) C5 injury involves: - ANS-1-quadriplegia-complete loss of
motor, sensory functions from neck down-including respiratory
2-quadriplegia-loss of all functions decreased upper shoulder level. phrenic nerve intact,
but not intercostal muscles
1) C6 injury
2) C7 injury
3) C8 injury involves: - ANS-1) quadriplegia-loss of function decreased shoulders &
upper arms. no use of intercostal muscles
, 2) incomplete quad loss of motor control to parts of arm & hand. loss of sensation
decreased clavicle & parts of arm/hand. 0 intercostals
3) incomplete quad 0 motor to parts of hand/arm. 0 sensation deceased chest/part of
hand. 0 intercostal
1) T1-T6 injury
2) T6-T12 injury
3)L1-L4 injury involves: - ANS-1. paraplegia. 0 motor function decreased mid chest,
including trunk muscles. 0 sensation from mid chest decreased, including lower limbs,
phrenic nerve functions independently some use of intercostal
2) paraplegia. 0 motor control/sensation decreased waist. 0 interference on respirations
3) paraplegia. loss of motor most of legs/pelvic area. 0 sensation to lower abd/legs
1) L3-L4 injury
2) L4-Sz injury involves: - ANS-1) incomplete para. 0 control/function or part of lower
legs/ankles/feet
2. incomplete paraplegia varying degrees of loss can walk with braces. may use
wheelchair & can be pretty independent
Signs of autonomic hyperretlecia : - ANS--paraxysmal ^BP, headache, vasodilation,
flushing, sweating, goosebumps ^ with SCI
-also spasticity of muscles & orthostatic hypotension possible
myasthenca gravis patient concerns: - ANS--chronic, progressive, causes voluntary
weakness
-improvement with rest/anticholinesterasemeds
-myasthenia crisis can be from exacerbation or too much anticholinesterase meds >
real. difficulty wracking in muscles including muscles in throat
-meds & pyndostigmin, heostigmin can be reversed by many anesthesia meds
-watch for real. distress aspiration, difficulty talking/swallowing auscultate lungs, SPO2
-^risk of infection
Caring for autistic patient - ANS--do not insist on eye contact. provide language tools-
-get info from caregiver about likes/dislikes, skills & abilities
-determine it from vitamins/what food has been cut from diet
infancy development and lifespan care - ANS--oral stage (freud)
-trust vs. mistrust (erickson)
-sensorimotor period (piagets)
-birth-12 months
