NFDN 2005 Unit 5-8 For Final questions
with solutions
What are the signs and symptoms of sickle-cell anemia? - ANSWER Slight stature (lack of
oxygen) with enlarged, protruding abdomen
Severe bone and abdominal pain during a crisis
cephalocaudal - ANSWER head to toe
Infant Respiratory Assessment I - ANSWER What are your assessment findings?
Retractions
Accessory muscle use
Grunting - not getting enough O2
Pediatric Respiratory Assessment II - ANSWER What are your assessment findings?
Stridor
Accessory muscle use
retractions
Nursing Care- Mouth Breathers - ANSWER Humidifier (warm v cold) - mist keeps mucus
membranes moist, reduce irritation/inflammation
Nursing Care- Nose breathers - ANSWER may need to suction boogers out of nose
Acute Nasopharyngitis - ANSWER Viral ("common cold")
Babies are at greater risk because they are obligate nose breathers
,How can parents effectively treat these infections?
Tylenol- may need to teach how to administer
Saline drops in nose to loosen mucus then suction out/ blow nose
Hydration
rest
Acute Nasopharyngitis Diagnosis - ANSWER History - vaccinations, onset, prior diagnosis, other
family members, exposure - childcare/daycare
physical exam
How many infections per year are normal in a child? - ANSWER 8-12 colds per year from age 1-5
Double that if in day care
What medical history would make a child at greater risk for complications in Acute
Nasopharyngitis? - ANSWER Cardiac or respiratory conditions, immunocompromised
When should a parent come back after a child is diagnosed with acute nasopharyngitis -
ANSWER If child is unable to breathe
If child looks blue
If child becomes severely lethargic and parent is concerned
Cough suppressants - ANSWER check ingredients for extra Tylenol
Not recommended under 5
Want them to cough
Most contains alcohol - will make them more lethargic
What is tonsillitis? - ANSWER Inflammation of the tonsils
,May be viral or bacterial
Swab to confirm
Enlarged tonsils/pharynx
Visible exudate
Swollen uvula
Fever, headache, abdominal pain
What is the appropriate treatment for tonsillitis? - ANSWER Antibiotics, if bacterial
Penicillin x 10 days (oral)
What are some complications of tonsillitis? - ANSWER Dehydration, obstruction, pain, pus &
abscess
When would a tonsillectomy be considered? - ANSWER Usually ~6 infections per year
What is the major complication for tonsillectomy? - ANSWER Bleeding/hemorrhage
What type of diet should be given after tonsillectomy? - ANSWER NORMAL diet, although avoid
red/brown coloured fluids
Pharyngitis - ANSWER Need to rule out Group A-beta hemolytic streptococci (GABHS): strep
throat
At risk of rheumatic fever, if GABHS not treated
Inflammatory disease of heart, joints, CNS, acute glomerulonephritis
GET ANTIBIOTICS
What is croup? - ANSWER Nasty cough
, Inflammation of the upper airway (larynx and trachea)
viral
How do we treat Croupe? - ANSWER steroids
Racemic epinephrine
Check pulse - can ^
Oral dexamethasone
What is the #1 priority when caring for a child with croup? - ANSWER Keep the child CALM
What happens in epiglottitis? - ANSWER Epiglottis becomes inflamed high fever, drooling,
Lymph nodes swollen
How is epiglottitis diagnosed? - ANSWER Lateral neck X-ray
NEVER look in the throat
Can cause throat to swell shut
Ensure have airway supplies available
What is the treatment for epiglottitis? - ANSWER IV antibiotics, oral dex (steroid)
Hospitalize due to risk of airway obstruction
Steroids - can cause moon face, don't stop suddenly
If children <4 years in the same house - 4 days of rifampin (antibiotic)
What causes nosebleeds? - ANSWER Injury
Nose picking
Thin nasal membranes
with solutions
What are the signs and symptoms of sickle-cell anemia? - ANSWER Slight stature (lack of
oxygen) with enlarged, protruding abdomen
Severe bone and abdominal pain during a crisis
cephalocaudal - ANSWER head to toe
Infant Respiratory Assessment I - ANSWER What are your assessment findings?
Retractions
Accessory muscle use
Grunting - not getting enough O2
Pediatric Respiratory Assessment II - ANSWER What are your assessment findings?
Stridor
Accessory muscle use
retractions
Nursing Care- Mouth Breathers - ANSWER Humidifier (warm v cold) - mist keeps mucus
membranes moist, reduce irritation/inflammation
Nursing Care- Nose breathers - ANSWER may need to suction boogers out of nose
Acute Nasopharyngitis - ANSWER Viral ("common cold")
Babies are at greater risk because they are obligate nose breathers
,How can parents effectively treat these infections?
Tylenol- may need to teach how to administer
Saline drops in nose to loosen mucus then suction out/ blow nose
Hydration
rest
Acute Nasopharyngitis Diagnosis - ANSWER History - vaccinations, onset, prior diagnosis, other
family members, exposure - childcare/daycare
physical exam
How many infections per year are normal in a child? - ANSWER 8-12 colds per year from age 1-5
Double that if in day care
What medical history would make a child at greater risk for complications in Acute
Nasopharyngitis? - ANSWER Cardiac or respiratory conditions, immunocompromised
When should a parent come back after a child is diagnosed with acute nasopharyngitis -
ANSWER If child is unable to breathe
If child looks blue
If child becomes severely lethargic and parent is concerned
Cough suppressants - ANSWER check ingredients for extra Tylenol
Not recommended under 5
Want them to cough
Most contains alcohol - will make them more lethargic
What is tonsillitis? - ANSWER Inflammation of the tonsils
,May be viral or bacterial
Swab to confirm
Enlarged tonsils/pharynx
Visible exudate
Swollen uvula
Fever, headache, abdominal pain
What is the appropriate treatment for tonsillitis? - ANSWER Antibiotics, if bacterial
Penicillin x 10 days (oral)
What are some complications of tonsillitis? - ANSWER Dehydration, obstruction, pain, pus &
abscess
When would a tonsillectomy be considered? - ANSWER Usually ~6 infections per year
What is the major complication for tonsillectomy? - ANSWER Bleeding/hemorrhage
What type of diet should be given after tonsillectomy? - ANSWER NORMAL diet, although avoid
red/brown coloured fluids
Pharyngitis - ANSWER Need to rule out Group A-beta hemolytic streptococci (GABHS): strep
throat
At risk of rheumatic fever, if GABHS not treated
Inflammatory disease of heart, joints, CNS, acute glomerulonephritis
GET ANTIBIOTICS
What is croup? - ANSWER Nasty cough
, Inflammation of the upper airway (larynx and trachea)
viral
How do we treat Croupe? - ANSWER steroids
Racemic epinephrine
Check pulse - can ^
Oral dexamethasone
What is the #1 priority when caring for a child with croup? - ANSWER Keep the child CALM
What happens in epiglottitis? - ANSWER Epiglottis becomes inflamed high fever, drooling,
Lymph nodes swollen
How is epiglottitis diagnosed? - ANSWER Lateral neck X-ray
NEVER look in the throat
Can cause throat to swell shut
Ensure have airway supplies available
What is the treatment for epiglottitis? - ANSWER IV antibiotics, oral dex (steroid)
Hospitalize due to risk of airway obstruction
Steroids - can cause moon face, don't stop suddenly
If children <4 years in the same house - 4 days of rifampin (antibiotic)
What causes nosebleeds? - ANSWER Injury
Nose picking
Thin nasal membranes
