PEDIATRIC NURSING - ABNORMALS
SUMMARY OF FUNCTIONAL CONCEPTS
Edited by: Lyzander A. Sardonido, RN
RESPIRATORY DISTURBANCES
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Complications of frequent tonsillitis: Rheumatic Fever, Rheumatic Heart Disease and Glomerulonephritis.
Tonsillectomy is not done when the tonsils is inflamed because it could lead to septicemia.
Tonsillectomy is a type of plan required surgery.
Diet following tonsillectomy is cool, clear liquid, non-irritating foods. AVOID red or brown colored foods.
EPIGLOTTITIS is always an emergency situation.
AVOID throat inspection/ gag reflex elicitation using tongue depressor for patient with epiglottitis or LTB.
The primary function of humidification therapy (mist tent) is to liquefy secretions.
DUST MITES are the common allergen that induces bronchial asthma attack.
In choosing an activity to a patient with bronchial asthma, the priority is to
(1) promote lung expansion, followed with
(2) preventing asthma attack
The triad symptoms of bronchial asthma are
a. Bronchoconstriction
b. Airway obstruction/ bronchospasm
c. Mucus production
Mucus production is cause by goblet cells.
Pediatric clients are prone to otitis media due to the anatomical structure of Eustachian tube which is
SHORTER and STRAIGHTER.
Otitis media is commonly cause by:
a. Propping the bottle
b. Passive smoking
c. Frequent tonsillitis
Otalgia is tugging of the ear that indicates otitis media
Mastoiditis and meningitis are the common complication of otitis media.
CARDIOVASCULAR DISTURBANCES
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In patients with CONGENITAL HEART DEFECTS, growth retardation is the common manifestation.
In patients with ACYANOTIC HEART DEFECTS, dyspnea is the common manifestation.
In patients with CYANOTIC HEART DEFECTS, cyanosis/ clubbing of fingers is the common manifestation.
Babies with CYANOTIC heart defects are commonly called as “Blue Babies” and usually experiences “tet
spells”
During tet spells, the nurse should positioon the patient into knee-chest/ squatting position.
Complication of acyanotic heart defects is Congestive Heart Failure; Complication of cyanotic heart defect
is polycythemia, thrombus formation and coma
Coarctation of Aorta has hypertension on upper extremities and hypotension in lower extremities.
Patent Ductus Arteriosus (PDA) has machinery murmur.
Tetralogy of Fallot (TOF) is composed of 4 cardiac defects:
a. Pulmonic stenosis
c. Ventricular Septal defect
b. Right Ventricular Hypertrophy
d. Overriding of the Aorta
Blalock Taussig procedure is a palliative surgery for TOF; wherein the surgeon make a shunt between the
subclavian artery and pulmonary artery.
Prostaglandin inhibitor (Indomethacin, Ibuprofen and other NSAIDs) is used to promote closure of the
PDA, ASD and VSD.
Diagnostic test of Rheumatic Heart Disease is Jones Criteria.
Kawasaki disease is systemic vasculitis; complications are aneurysm and thrombus formation.
Standard management for Kawasaki disease is the administration of immunoglobulin and aspirin.
The aspirin property that primarily treats Kawasaki disease is the anti-inflammatory property.
Cardiac development is fairly complete by 8 weeks of gestation.
Purpose of the ductus arteriosus during fetal circulation is to divert blood from the fetal lungs to the fetal
aorta
The heart is the size of the FIST
After birth the pulmonary artery is the only artery in the body that CARRIES DEOXYGENATED BLOOD
Cardiac output = heart rate times stroke volume
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PEDIATRIC NURSING, 2011, Edited by: Lyzander A. Sardonido, RN.. 09269014245
Copyright 2011. Please do not reproduce or use without the author’s permission.
NEUROLOGIC DISTURBANCES
36. Common cause of neural tube defects: low folic acid (folate) intake during pregnancy
37. Common types of neural tube defect:
(1) Spina bifida occulta and
(2) spina bifida cystic (meningocele and myelomeningocele)
38. Priority management for Neural tube defect:
(1) prevent trauma to the sac/ prevent injury and
(2) prevent infection and complication
39. Priority management in patients with Neural Tube Defects is to prevent rupture of the sac.
40. Arnold-Chiari malformation (Chiari II malformation) by Julius Arnold, Hans Chiari: ACM is the overgrowth
of cerebellum and medulla (neural tube) and pushed down through the foramen magnum, blocking flow
of CSF. It is associated with myelomeningocele: it is manifested by, Stridor/ breathing difficulties,
Weakness of Upper and lower limbs, and Swallowing difficulties.
41. Priority for seizure disorders is SAFETY.
42. Cerebral palsy is a permanent, non-progressive, motor function impairement.
43. Epilepsy is described as “recurrent seizure”
44. Post-op position for patient with hydrocephalus who underwent shunting procedure ois sidelying to the
unopperative site or low fowler’s position (up to 30 degrees ONLY)
45. Patient with Increased Intracranial pressure has the following vital signs:
(1) Increased BP
(2) Decresaed RR and PR
(3) Widening pulse pressure
GASTROINTESTINAL DISTURBANCES
46. Priority management in patients with cleft lip and cleft palate following surgery is to prevent rupture of
the suture line.
47. In pyloric stenosis, frequent, projectile, non-bile stained vomitus is a common manifestation.
48. In pyloric stenosis, there is no bile in the vomitus because the obstruction is above the ampulla of Vater
(duodenal ampulla).
49. Surgery for pyloric stenosis is pyloromyotomy (Fredet Ramstedt procedure)
50. The 3 classical signs of intussusception are:
(1) intermittent abdominal pain
(2) currant jelly stool, and
(3) sausage-shaped mass.
51. The surgical intervention for intussusception is hydrostatic reduction surgery using enema (barium or airwater) and/or resection and anastomosis.
52. Hirschprung’s disease (Aganglionic Megacolon) is manifested by pellet-like stools/ ribbon like stools/
constipation.
53. The common cause of death in a child with cystic fibrosis is respiratory problem.
54. Foods to be AVOIDED by a patient with celiac disease (celiac sprue/ gluten-sensitivity enteropathy) are
Barley, Rye, Oats, and Wheat.
55. Foods that are ALLOWED by a patient with celiac disease are white rice, potatoes and corn.
56. Newborns and infants have a 10- to 20-milliliter stomach capacity at birth
57. Infants can absorb the fat in breast milk more readily than fat in formula because human breast milk
contains lipase
58. During the newborn assessment, the nurse will examine the palate by palpation with a gloved finger
59. ESSR stands for Enlarge, Stimulate, Swallow, and Rest. ESSR is the international feeding method for cleft
lip and cleft palate patients.
60. Tracheoesophageal atresia with esophageal atresia, signs:
(1) Chocking
(2) Coughing
(3) Cyanosis
GENITORINARY DISTURBANCES
61. Wilm’s tumor (nephroblastoma) is a kidney cancer in children. The tumor is usually unilateral, palpable,
painless, soft, abdominal mass.
62. Bilateral tumor and dyspnea are manifestation of late signs of Wilm’s tumor.
63. Priority in Wilm’s tumor: “DO NOT PALPATE”
64. Wilm’s tumor is the 2nd most common cancer in children.
65. Common complication of crytorchidism is sterility or testicular cancer.
66. Epispadias has dorsal opening in the meatus and associated with exstrophy of the bladder.
67. Hypospadias has ventral opening in the meatus and associated with chordee.
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PEDIATRIC NURSING, 2011, Edited by: Lyzander A. Sardonido, RN.. 09269014245
Copyright 2011. Please do not reproduce or use without the author’s permission.
68. Chordee is abnormal downward curvature of the penis.
69. Corrective surgery for epispadias and hypospadias is done BEFORE toilet training.
70. 4 Hallmark manifestations of Nephrotic syndrome (Nephrosis):
(1) Proteinuria
(3) Edema (anasarca)
(2) Hypoproteinemia
(4) Hypercholesterolemia
MUSCULO-SKELETAL DISTURBANCES
71. In Bryant’s traction, make sure that the buttocks are off the bed.
72. Priority nursing diagnosis in a patient with skin traction is Impaired Skin Integrity.
73. Developmental hip displasia (DHD)/ Congenital Hip Dislocation (CHD) is the separation of the femoral
head from the acetabulum.
74. Priority management for DHD: ABDUCT the affected leg
75. Management for scoliosis: Milwaukee brace and Harrington rod instrumentation.
76. Fat is stored inthe yellow marrow of the medullary cavity of the bones
77. Hematopoiesis occurs in the red marrow of the medullary cavity of the bone.
78. In cervical traction, the head of the bed be elevated by 20-30 degree.
79. Treatments used for compartment syndrome are split the cast if one is present or do a fasciotomy to
relieve pressure.
80. An early sign of compartment syndrome is the sudden inability of the medications to relieve pain
HEMATOLOGIC DISTURBANCES
81. To prevent sickle cell crisis, avoid 3 things:
(1) hypoxia/ respiratory acidosis,
(2) metabolic acidosis, and
(3) dehydration
82. The priority management in sickle cell anemia is:
(1) Hydration
(2) Oxygen
(3) Pain management
83. Iron supplements should be given before meals to promote proper absorption of the gastric acidity except
for ferrous sulfate because it is irritating to the stomach.
84. BLEEDING PRECAUTION is composed of P.E.C.A.T:
Pressure site, Elevate above the heart, Cold compress, Arterial pressure, Tourniquet.
85. Hemophilia A and B is X-linked inherited.
86. Leukemia is the MOST COMMON cancer in children.
87. CHEMOTHERAPY is the best treatment modality is pediatric oncology.
88. During fetal development, blood cells produced in the liver and spleen
89. Features of red blood cells (RBCs) allow them to reach all the tissues of the body: shape, size, and
structure
90. The most common blood disorder in children is ANEMIA
INTEGUMENTARY DISTURBANCES
91. To prevent diaper rash, the best is to use absorbent diapers.
92. Permethrin (Nix) is the drug of choice for Pediculosis capitis.
93. Lindane (Kwell) is used commonly for scabies. It must be avoided below 2 months of age because Lindane
is neurotoxic.
94. Classic sign of impetigo is honey-colored crusts on the skin
95. Staphylococcus aureus is the common cause of bullous impetigo
CHILD ABUSE AND NEGLECT
96. CHILD MALTREATMENT is the intentional injury of a child
97. Physical abuse is the bodily injury to a person that seems to have been inflicted by other than accidental
means
98. The majority of perpetrators of abuse to children are PARENTS
99. The most common type of mistreatment of children is NEGLECT
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According to the social-interactional systemic perspective of child abuse and neglect, four factors
place the family members at risk for abuse. These risk factors are
(1) the family itself
(3) the child
(2) the caregiver
(4) the presence of a family crisis
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PEDIATRIC NURSING, 2011, Edited by: Lyzander A. Sardonido, RN.. 09269014245
Copyright 2011. Please do not reproduce or use without the author’s permission.