PEDs Sig

Question 1

What needs to be in the room

Answer 1

Med Sheet
Ambo bag
Suction & O2

Question 2

epiglottitis interventions

Answer 2

maintain the airway
-no tongue blades, do not look in throat
-avoid xray & transport (portal if needed)
-let parents be w/ child & keep everyone calm
-prepare for sedation & intubation -> antibiotic -> extubate

Question 3

Constipation management

Answer 3

After 6mo
1. Fluids (H2O)
2. Add fruit juice to help pull water in colon
3. Miralax

Question 4

What foods are choking hazards

Answer 4

• grapes
• hard candy
• popcorn
• hot dogs
• raw mini carrots
• smooth hard foods

Question 5

What should be done even everytime you are given a new patient, even if it is just to cover a patient for a few mins?

Answer 5

You should always access the pt and do the vitals and check orders always

Quick look- all details - all PTs - All the time

Question 6

How to access an IV and Pump

Answer 6

IV site -> tubing -> pump -> bag

Question 7

If a patient is stable but declining, who should you call?

Answer 7

Call Rapid Response

Question 8

What if the patient is unstable and needs needs help now?

Answer 8

Call a Code Blue

Question 9

What should you do for interventions?

Answer 9

Access the patient first -> Do the intervention -> Always re-access

Question 10

aggressive airway clearance for CF (need to know)

Answer 10

• percussion by manual, PEP mask and vest
• airway clearance therapy
• postural drainage
• breathing exercises
• physical exercise
• oxygen therapy & nebs only if needed bc hard to wean
• isolation while in hospital

Question 11

cyanotic spells O2 consideration

Answer 11

• acyanotic- don’t give O2 (tissue generally have O2)
• Cyanotic- give O2

Question 12

discharge planning post cardiac cath

Answer 12

• pressure dressing x24 hr
• no tub baths for 48hrs
• rest 1 night then can resume activities
• teach S/s of infections

Question 13

holliday segar formula

Answer 13

need to have memorized
-first 10kg add 100 ml/kg/d
-next 10kg add 50 ml/kg/d
->20kg add 20 ml/kg/d
ex) 7kg child would get 700 ml
ex) 12kg (10x100)+(2x50) = 1100 ml
ex) 30kg (10x100)+(10X50)+(10x20) =
1700 ml
divide by 24 to get per hr

Question 14

What to think about regarding pain?

Answer 14

Think about s/s and development status. Children may lie.

Question 15

What age can you start using Wong-baker face pain scale?

Answer 15

Depending on development but around 3y/o

Question 16

FLACC SCALE - pain scale

Answer 16

FACIAL EXPRESSIONS
LEG MOVEMENT
ACTIVITY
CRY
CONSOLABILITY

Question 17

Infants and Toddlers (0-3 years): Non-pharmacological techniques ideas

Answer 17

Swaddling
Skin-to-skin contact
Pacifiers
Rocking or gentle movement
Soft music or white noise

Question 18

Preschoolers (3-5 years): Non-pharmacological techniques ideas

Answer 18

Distraction with toys, bubbles, or videos
Simple breathing exercises
Comfort positioning
Guided imagery (e.g., imagining favorite places)

Question 19

School-age Children (6-12 years): Non-pharmacological techniques ideas

Answer 19

School-age Children (6-12 years):
Distraction with games, books, or electronic devices
Deep breathing techniques
Progressive muscle relaxation
Guided imagery
Music therapy

Question 20

Adolescents (13-18 years): Non-pharmacological techniques ideas

Answer 20

Relaxation techniques
Guided imagery
Music or art therapy
Cognitive-behavioral strategies
Mindfulness exercises

Question 21

Intussusception Invagination or telescoping of one portion of the intestine into another. Nursing Consideration & teaching

Answer 21

recognize symp and refer tx, NG tube for decompress, monitor signs of shock, ABX, hydration and nutrition, routine post-op care, family support

Question 22

TEF failure of the esophagus Preop - Nursing Consideration & teaching

Answer 22

• preop: early detection, maintenance of airway, prevention of PNA, gastric or blind pouch decompression, ABX, prep for surgical correction

Question 23

how much do you increase fluid needs by for a fever

Answer 23

by 7ml/kg/d

Question 24

Remember safe dose range

Answer 24

Example: 1-2mg/kg/d

1mg x 2.2kg / 4 (if every 6hr) lower
2mg x 2.2kg / 4 (if every 6hr) upper

if pounds are given most divide by 2.2 to get kg first

Question 25

infant weight

Answer 25

-lose 10% after birth -gain 1oz/d (5-7 oz/wk) until 6 mo -doubles wt by 6 mo -triples wt by 1 yr

Question 26

Erikson: infant

Answer 26

trust vs mistrust by someone meeting their needs (parents must be in sync w/ child) ex: when baby cries, do they get picked up or fed **if needs meet, more trusting for the rest of their life**

Question 27

piaget sensorimotor age group

Answer 27

birth until 2y/o

Question 28

Erikson: toddler

Answer 28

autonomy vs shame & doubt

Question 29

piaget preoperation age group

Answer 29

2 until 6 y/o (school age)

Question 30

Erikson: preschooler

Answer 30

initiative vs guilt

Question 31

piaget operaiton age group

Answer 31

school age

Question 32

Erikson: school ager

Answer 32

industry vs inferiority

Question 33

what is the timeline for sitting without support

Answer 33

-6mo: sit w/ support -7mo: sit alone in tripod **-8mo: can sit unsupported** -10mo: can go into a sitting position from prone or supine

Question 34

when can an infant crawl & when can they creep

Answer 34

-crawl (belly on floor) by 8-10 mo -creep (belly off floor) by 11 mo

Question 35

what is the timeline for holding own head up

Answer 35

-1mo: marked head lag -3mo: can hold head up -4/6mo: well established head control **no head lag by 6mo**

Question 36

when does walking happen

Answer 36

-by 12mo, walks well w/ one hand being held and the other out for balance -walking alone by 15mo **wide base**

Question 37

how many cubes can a toddler stack at 15mo, 18mo, 24mo & 3yr

Answer 37

-2 -3 to 4 -6 to 7 -9

Question 38

Insulin dosing

Answer 38

**will be on exam, sig & final** -ratio: 1 unit for every 18g carbs -correction: 1 unit for every 50 above BG of 150 example) BS 227, 48 carbs consumed -> 227-150 = 77/50 -> 1.54 units & 48/18 = 2.66 units total insulin needed = 1.54 + 2.66 = 4.2 units

Question 39

what food is 15grams of carbs

Answer 39

-small pack of skittles -8oz of white milk **no chocolate milk** -4oz of orange or apple juice ~frosting, starbursts -glucose tabs **honey if over 1yr**

Question 40

If a child is having trouble breathing and needs O2 what should you do before if needed?

Answer 40

Suction before O2.

Question 41

What is normal urine output?

Answer 41

1-2mL/kg/hour ***Not sure on this***

Question 42

How to calculate ANC & interp?

Answer 42

Total Neutrophil % (segs% +bands%) x Total WBC = ANC ***Below 1000 Neutropenic** ***<500 - Critical**

Question 43

What precautions for low Platelets?

Answer 43

* >100,000-normal - No contact sports - Protective equipment such as bike helmets when riding a bike * 50,000-100,000 - Padding with activity - Protective equipment such as bike helmets when riding a bike * <50,000 - Extreme caution as kids can spontaneously bleed in their head - Quiet activities