WVU NSG 320 Exam 3 Content Questions With Complete
Solutions
What are some things we should know about the pediatric
immune system/physiology?
-immature immune system responses make infants and young
children more susceptible to infection
^remember, infants and children have this weird thing about
putting their hands in their mouth; children love to put their
hands on everything too, so this increases the spread of germs
-newborns have a decreased inflammatory response to invading
organisms, which contributes to their risk for infection
-infants have limited exposure to diseases and start losing the
passive immunity acquired from maternal antibodies, which
places them at risk for infection
-disease protection from immunizations is incomplete
^it takes a while to get immunity from the immunization
What are common labs done for infectious conditions?
-blood
-blood culture
-stool culture
-urine culture
-throat culture
-wound culture
-spinal fluid culture
,What are blood draws/cultures?
-venipuncture
-atraumatic care (pain control)
-safe area
^their room should be a place where no procedures are done
^we should take them to the treatment room for any tests or
procedures
-capillary puncture
^heel or finger stick
-venous access device
^when we get blood from a PICC line, we need to flush the IV
and then pull back for blood. When the syringe is filled with
blood, this is your discard. Make sure you know which syringe
is your discard and which one is for lab analysis. When you are
done, flush with saline/heparin
-this should be done with sterile technique!
-we want to ask ourselves, "What is the minimum amount of
blood that I need to run this test?"
-we also need to ask ourselves if it is necessary to do another
blood draw
^if the lab work isn't pertinent to changing the treatment plan or
diagnosis, then we should probably question it
What are specific things that we can pinpoint in blood cultures?
,WBCs
-differential aids in diagnosis
Erythrocyte Sedimentation Rate (ESR)
-detects inflammation and infection
C-Reactive Protein
-measures protein produced in the liver during inflammation
-rises with bacterial infection
What is urine testing?
Midstream Clean Catch
-we need to be sure that this is appropriate for their age
-if they haven't been potty trained yet, this is probably not the
best option
-make sure that the child is able to understand the directions and
is able to teach back to you
Catheterization
-standard of care for a child with a fever
"Bagged"
-if you don't have it sealed well, they will just pee around it
-this typically works better for males than females
Cotton Balls
-we will put cotton balls in diapers in order to absorb the urine
for testing
-once the cotton balls have become soiled, we put them in a 60
ml syringe and squeeze the urine into a cup
Considerations
-collect the urine before you administer ABX
-figure out when the child last used the restroom
-get fluid in the child a little bit before the specimen collection
, What is spinal fluid testing?
Lumbar Puncture
-child is placed in a knee to chest position
-we are looking for increased WBC and decreased glucose (this
indicates infection)
Atraumatic Care
-EMLA cream on the back at least an hour before the puncture
Considerations
-if they have been doing multiple sticks and nothing is occuring,
someone else needs to try (this is advocation)
-always assess to see if the child is doing well during the
procedure
What are considerations that we should take for each culture
test?
Blood Cultures
-obtain before starting ABX
-sterile technique
-we look at growth within 24 hrs, 48 hrs, and 72 hrs
Stool
-determine if bacteria or parasite has infected the intestines
Throat Culture
-vigorous swabbing of the tonsillar area and posterior pharynx to
detect the presence of invasive organisms
-we might be doing this to test strep throat
-they aren't pleasant, and they often make the patient gag
-have the patient sit on parent's lap, and have the parent bear hug
them so the child doesn't try to pull the swab out
Solutions
What are some things we should know about the pediatric
immune system/physiology?
-immature immune system responses make infants and young
children more susceptible to infection
^remember, infants and children have this weird thing about
putting their hands in their mouth; children love to put their
hands on everything too, so this increases the spread of germs
-newborns have a decreased inflammatory response to invading
organisms, which contributes to their risk for infection
-infants have limited exposure to diseases and start losing the
passive immunity acquired from maternal antibodies, which
places them at risk for infection
-disease protection from immunizations is incomplete
^it takes a while to get immunity from the immunization
What are common labs done for infectious conditions?
-blood
-blood culture
-stool culture
-urine culture
-throat culture
-wound culture
-spinal fluid culture
,What are blood draws/cultures?
-venipuncture
-atraumatic care (pain control)
-safe area
^their room should be a place where no procedures are done
^we should take them to the treatment room for any tests or
procedures
-capillary puncture
^heel or finger stick
-venous access device
^when we get blood from a PICC line, we need to flush the IV
and then pull back for blood. When the syringe is filled with
blood, this is your discard. Make sure you know which syringe
is your discard and which one is for lab analysis. When you are
done, flush with saline/heparin
-this should be done with sterile technique!
-we want to ask ourselves, "What is the minimum amount of
blood that I need to run this test?"
-we also need to ask ourselves if it is necessary to do another
blood draw
^if the lab work isn't pertinent to changing the treatment plan or
diagnosis, then we should probably question it
What are specific things that we can pinpoint in blood cultures?
,WBCs
-differential aids in diagnosis
Erythrocyte Sedimentation Rate (ESR)
-detects inflammation and infection
C-Reactive Protein
-measures protein produced in the liver during inflammation
-rises with bacterial infection
What is urine testing?
Midstream Clean Catch
-we need to be sure that this is appropriate for their age
-if they haven't been potty trained yet, this is probably not the
best option
-make sure that the child is able to understand the directions and
is able to teach back to you
Catheterization
-standard of care for a child with a fever
"Bagged"
-if you don't have it sealed well, they will just pee around it
-this typically works better for males than females
Cotton Balls
-we will put cotton balls in diapers in order to absorb the urine
for testing
-once the cotton balls have become soiled, we put them in a 60
ml syringe and squeeze the urine into a cup
Considerations
-collect the urine before you administer ABX
-figure out when the child last used the restroom
-get fluid in the child a little bit before the specimen collection
, What is spinal fluid testing?
Lumbar Puncture
-child is placed in a knee to chest position
-we are looking for increased WBC and decreased glucose (this
indicates infection)
Atraumatic Care
-EMLA cream on the back at least an hour before the puncture
Considerations
-if they have been doing multiple sticks and nothing is occuring,
someone else needs to try (this is advocation)
-always assess to see if the child is doing well during the
procedure
What are considerations that we should take for each culture
test?
Blood Cultures
-obtain before starting ABX
-sterile technique
-we look at growth within 24 hrs, 48 hrs, and 72 hrs
Stool
-determine if bacteria or parasite has infected the intestines
Throat Culture
-vigorous swabbing of the tonsillar area and posterior pharynx to
detect the presence of invasive organisms
-we might be doing this to test strep throat
-they aren't pleasant, and they often make the patient gag
-have the patient sit on parent's lap, and have the parent bear hug
them so the child doesn't try to pull the swab out
