PEDIATRICS CMS REVIEW
1. Tetralogy of fallot causes cyanosis;
a. This causes increased RBC production (polycythemia) in an attempt to supply
oxygen to all body parts
b. KNEE CHEST POSITION (heypercyanotic)
2. The nurse should monitor the extremity to ensure the swelling does NOT increase, and
cause the cast to become too tight, which can result to impaired circulation.
a. This puts the child at risk for compartment syndrome.
3. Immediately following the injury and for at least the 48 hours
a. the child should keep the affected limb ABOVE the level of the heart
i. to help prevent edema and pain to promote venous return.
4. Phototherapy promotes bilirubin excretion by changing the structure of bilirubin into a
form which can be excreted through the bowel.
a. The presence of green stools indicate accelerated bilirubin excretion.
5. The parent should encourage the child to remain physically ACTIVE
a. because this promotes lung expansion and air exchange.
6. BMI Calculation: weight (kg)/[height (m)]^2 or 703 x weight (lbs)/ [height (in)]^2
7. Equivalency: 1kg = 2.2 lb
Usual dose: 10mg/kg
How many mL per dose?
Weight of the childs is 25 lbs.
Change to kg is 11.4 kg
11.4kg x 10mg= 114mg
How the med comes: 160 mg/5mL
Equation:
160/114 mg = 5 mL/x
160x= 570/160
x=3.6mL
❏ 3-year-olds
-can put shoes on!
❏ 4-year-olds
-buttons on a shirt
-use scissors
, ❏ 5-year-olds
-shoelaces
-days of the week
- can balance on a foot with eyes closed.
❏ 7-year-olds
- comb hair
- cut meat w/ knife.
8. Appropriate diversional activity:
a. Preschool:
-large pieces puzzle
-building blocks
b. Toddler:
-painting
-finger painting
c. School age:
-chapter books
9. Indication of increased intracranial pressure (ICP): BHIB
a. bulging fontanel
b. a high-pitched cry
c. increased sleeping
d. Bradycardia
10. Visual acuity test:
a. let the child wear her glasses during the screening
b. position child 3m (10ft) AWAY-> from the Snellen chart.
c. Start testing the RIGHT eye (cover left eye first).
d. Have the child read the 20/20 line first.
i. If they are unable to do so, they should move up to the next larger line of
letters on the chart until the child can read at least 4 out of 6 letters
correctly.
11. Manifestations of Diabetes Ketoacidosis:
a. Kussmaul respirations (deep and rapid respirations)
b. Tachycardia (increased heart rate)
c. sunken eyeballs
d. increased urinary output
,12. Manifestation of untreated congenital HYPOthyroidism: (CED)**
a. constipation
b. enlarged abdomen
c. hyporeflexia
d. decreased muscle tone
e. dry, scaly skin
f. hypothermia
g. cool extremities
13. If a baby has a cleft palate --
a. The nurse should explain that we need to wait NO LONGER than the child is 6-
12 months (up to 1 year) to avoid difficulty with language acquisition.
14. Post-op care for cleft palate repair:
a. SIDE LYING position - to allow the drainage of blood and secretions and to
minimize the risk of aspiration.
b. No rigid objects
c. Clear liquids for 24 hours
d. Use FLACC to assess pain.
15. If a baby has sickle cell anemia and is experiencing a vaso-occlusive crisis --
a. give her ibuprofen or acetaminophen for mild to moderate pain.
b. If the pain does NOT go away, give the child an opioid analgesic.
16. Menarche is expected to occur around 10.5 to 15.5 years of age.
a. Females who have a higher body fat content have been shown to have an
earlier onset of menarche.
17. Use short explanations to preschool-aged children, so it limits their time to worry when
collecting blood glucose.
18. An 8-month old infant should be able to sit unsupported, use of pincer grasp begins at 8
months.
a. 7 months can say “dada”, 10 months can say “mama”.
b. 3 months begins to localize sound.
19. How kids play by age
a. Infants: solitary play
b. Toddlers: parallel play
, c. Preschoolers: associative play
d. School-aged children: cooperative play
20. Children who have glomerulonephritis:
a. should be weighed each day at the same time to monitor fluid balance
b. blood pressure should be monitored every 4 hours
c. child should NOT be on bedrest (participate in activities)
d. offer a child a regular diet with moderate sodium restriction and ensure no salt
is added to foods.
21. Acute POST- streptococcal glomerulonephritis s&s:
a. Hematuria
b. Hypertension
22. Children with CELIAC DISEASE
a. can eat gluten free food such as corn, rice, baked potato.
23. Children with APLASTIC ANEMIA
a. should be in PROTECTIVE ISOLATION
b. apply pressure to peripheral puncture sites for 5 minutes.
c. avoid mixing medications into liquids.
24. Interventions for post op VP shunt:
a. check for abdominal distention,
b. the child should be positioned flat (SUPINE).
25. Home care instruction for a school-aged child who has ACUTE Streptococcal
Pharyngitis:
a. have the child gargle with warm saline several times a day
b. replace the child’s toothbrush 24 hours AFTER the initiation of the antibiotics
(not right away),
c. child CAN return to school 24 hours AFTER the initiation of antibiotics,
d. don’t force the child to eat because pain might interfere.
26. If the infant is taking DIGOXIN ELIXIR
a. parent should withhold medication and notify provider if the infant’s heart
rate is LESS than 110/min,
b. do not mix medication with any liquids,
c. notify provider if child is VOMITING because it is a medication toxicity,
d. NO double dose of medication.
27. DIGOXIN toxicity:
a. Vomiting
b. bradycardia
1. Tetralogy of fallot causes cyanosis;
a. This causes increased RBC production (polycythemia) in an attempt to supply
oxygen to all body parts
b. KNEE CHEST POSITION (heypercyanotic)
2. The nurse should monitor the extremity to ensure the swelling does NOT increase, and
cause the cast to become too tight, which can result to impaired circulation.
a. This puts the child at risk for compartment syndrome.
3. Immediately following the injury and for at least the 48 hours
a. the child should keep the affected limb ABOVE the level of the heart
i. to help prevent edema and pain to promote venous return.
4. Phototherapy promotes bilirubin excretion by changing the structure of bilirubin into a
form which can be excreted through the bowel.
a. The presence of green stools indicate accelerated bilirubin excretion.
5. The parent should encourage the child to remain physically ACTIVE
a. because this promotes lung expansion and air exchange.
6. BMI Calculation: weight (kg)/[height (m)]^2 or 703 x weight (lbs)/ [height (in)]^2
7. Equivalency: 1kg = 2.2 lb
Usual dose: 10mg/kg
How many mL per dose?
Weight of the childs is 25 lbs.
Change to kg is 11.4 kg
11.4kg x 10mg= 114mg
How the med comes: 160 mg/5mL
Equation:
160/114 mg = 5 mL/x
160x= 570/160
x=3.6mL
❏ 3-year-olds
-can put shoes on!
❏ 4-year-olds
-buttons on a shirt
-use scissors
, ❏ 5-year-olds
-shoelaces
-days of the week
- can balance on a foot with eyes closed.
❏ 7-year-olds
- comb hair
- cut meat w/ knife.
8. Appropriate diversional activity:
a. Preschool:
-large pieces puzzle
-building blocks
b. Toddler:
-painting
-finger painting
c. School age:
-chapter books
9. Indication of increased intracranial pressure (ICP): BHIB
a. bulging fontanel
b. a high-pitched cry
c. increased sleeping
d. Bradycardia
10. Visual acuity test:
a. let the child wear her glasses during the screening
b. position child 3m (10ft) AWAY-> from the Snellen chart.
c. Start testing the RIGHT eye (cover left eye first).
d. Have the child read the 20/20 line first.
i. If they are unable to do so, they should move up to the next larger line of
letters on the chart until the child can read at least 4 out of 6 letters
correctly.
11. Manifestations of Diabetes Ketoacidosis:
a. Kussmaul respirations (deep and rapid respirations)
b. Tachycardia (increased heart rate)
c. sunken eyeballs
d. increased urinary output
,12. Manifestation of untreated congenital HYPOthyroidism: (CED)**
a. constipation
b. enlarged abdomen
c. hyporeflexia
d. decreased muscle tone
e. dry, scaly skin
f. hypothermia
g. cool extremities
13. If a baby has a cleft palate --
a. The nurse should explain that we need to wait NO LONGER than the child is 6-
12 months (up to 1 year) to avoid difficulty with language acquisition.
14. Post-op care for cleft palate repair:
a. SIDE LYING position - to allow the drainage of blood and secretions and to
minimize the risk of aspiration.
b. No rigid objects
c. Clear liquids for 24 hours
d. Use FLACC to assess pain.
15. If a baby has sickle cell anemia and is experiencing a vaso-occlusive crisis --
a. give her ibuprofen or acetaminophen for mild to moderate pain.
b. If the pain does NOT go away, give the child an opioid analgesic.
16. Menarche is expected to occur around 10.5 to 15.5 years of age.
a. Females who have a higher body fat content have been shown to have an
earlier onset of menarche.
17. Use short explanations to preschool-aged children, so it limits their time to worry when
collecting blood glucose.
18. An 8-month old infant should be able to sit unsupported, use of pincer grasp begins at 8
months.
a. 7 months can say “dada”, 10 months can say “mama”.
b. 3 months begins to localize sound.
19. How kids play by age
a. Infants: solitary play
b. Toddlers: parallel play
, c. Preschoolers: associative play
d. School-aged children: cooperative play
20. Children who have glomerulonephritis:
a. should be weighed each day at the same time to monitor fluid balance
b. blood pressure should be monitored every 4 hours
c. child should NOT be on bedrest (participate in activities)
d. offer a child a regular diet with moderate sodium restriction and ensure no salt
is added to foods.
21. Acute POST- streptococcal glomerulonephritis s&s:
a. Hematuria
b. Hypertension
22. Children with CELIAC DISEASE
a. can eat gluten free food such as corn, rice, baked potato.
23. Children with APLASTIC ANEMIA
a. should be in PROTECTIVE ISOLATION
b. apply pressure to peripheral puncture sites for 5 minutes.
c. avoid mixing medications into liquids.
24. Interventions for post op VP shunt:
a. check for abdominal distention,
b. the child should be positioned flat (SUPINE).
25. Home care instruction for a school-aged child who has ACUTE Streptococcal
Pharyngitis:
a. have the child gargle with warm saline several times a day
b. replace the child’s toothbrush 24 hours AFTER the initiation of the antibiotics
(not right away),
c. child CAN return to school 24 hours AFTER the initiation of antibiotics,
d. don’t force the child to eat because pain might interfere.
26. If the infant is taking DIGOXIN ELIXIR
a. parent should withhold medication and notify provider if the infant’s heart
rate is LESS than 110/min,
b. do not mix medication with any liquids,
c. notify provider if child is VOMITING because it is a medication toxicity,
d. NO double dose of medication.
27. DIGOXIN toxicity:
a. Vomiting
b. bradycardia
