ADN 221 Pediatrics test prep Exam with Answers & Rationale
3 views 0 purchase
Course
ADN 221
Institution
ADN 221
ADN 221 Pediatrics test prep Exam with Answers & Rationale
Kaplan Peds Rationale
2
1. Idiopathic Thrombocytopenia Purpura
○ A hemorrhagic autoimmune disorder that causes excessive destruction of platelets
○ Symptoms → sometimes NO symptoms...
blood in urine or stool iv heavy menstrual flow amp low plt count
systemic lupus erythematosus
Written for
ADN 221
All documents for this subject (1)
Seller
Follow
Cowell
Reviews received
Content preview
peds test - 75 topics
ADN 221 Pediatrics test prep Exam with Answers &
Rationale
Kaplan Peds Rationale
2
1. Idiopathic Thrombocytopenia Purpura
○ A hemorrhagic autoimmune disorder that causes excessive destruction of platelets
○ Symptoms → sometimes
NO symptoms
i. Purpura (easy/excessive bruising) & Petechiae ii.
Bleeding from gums/nose/mucus membranes iii.
Blood in urine or stool iv. Heavy menstrual flow
& low PLT count
○ Causes → immune system attacking its own platelets,
viral illness (flu/mumps)
○ Risk Factors → sulfa drugs, systemic lupus erythematosus, pregnancy,
, viruses
○ Diagnosis → CBC, blood smear, bone marrow exam (platelets are
produced in the bone marrow)
○ Labs → Platelets will be below 20,000. Normal range = 150,000-450,000
INR, PT & PTT high
○ Treatment → Acute ITP resolves spontaneously
within 6 months
i. Corticosteroids ii. Discontinuation of meds known to cause ITP
iii. Immunosuppressive agents & IV immune
globulin iv. Splenectomy & Chemotherapy
agents
○Nursing Considerations
i. Assess activities that increase risk for bleeding ii. Instruct client to avoid
aspirin & NSAID’s = high risk drugs for bleeding iii. Taking any sulfa-
based meds & any other PLT altering meds? iv. Avoid constipation &
using dental floss, use soft- bristled toothbrush
v.Instruct children about no contact sports, bike riding, skateboarding, climbing or running
vi. Encourage quiet activities vii. Inform HCP if there is head or abdomen trauma
○ Signs of Improvement → PLT count of
100,000- 400,000
→ A student nurse presents a conference on hematological disorders in children.
The student nurse identifies which information should be included.. presentation
about immune thrombocytopenia purpura (ITP)? Immune thrombocytopenia purpura
is caused by excessive destruction of platelets. There is discoloration due to petechiae, and
the bone marrow is normal.
2.Developmental Dysplasia of the Hip
● Definition → spectrum of conditions where there’s an abnormal relationship
between the proximal femur & acetabulum. There are 3 forms: dysplasia,
subluxation (mis-alignment of the vertebrae) & dislocation
●Signs & Symptoms
○ Asymmetrical skin folds (gluteal folds)
○Galeazzi sign (shortening of limb on affected side)
○Limited hip abduction & hip instability
○Lordosis (curvature of the lumbar and cervical regions of the human spine)
○Waddling gait
● Diagnostic Tests → Trendelenburg test (one leg up = opposite hip drops),
XRAY, MRI, US
● Treatment
○Pavlik harness (“overalls”), spica cast (legs) & surgical correction
●Nursing Care
, ○Reassure parents that early, prompt treatment will probably result in complete correction
3
○Encourage parent to stay with child during his/her first few days in cast/harness
○Spica Cast Treatment: keep cast dry & change child’s diapers often, turn Q2 &
Q4 at night, check color, sensation & motion of child’s legs & feet
○Give Benadryl if child complains of itching or cool blow dryer - Do NOT scratch with objects
○Encourage parents to let child sit at a table, floor & play with other kids (socialize)
○Watch for signs that the child is outgrowing the cast - cyanosis
→ The nurse cares for the 2-week-old infant diagnosed with developmental dysplasia
of the hip (DDH). The nurse notes which finding is consistent diagnosis of DDH?
Asymmetry of the gluteal folds.
3. Osteogenesis Imperfecta (Brittle Bone Disease) → inherited syndrome causing
fractures & bone deformities, most common osteoporosis syndrome in children
→ bones become brittle
●Signs & Symptoms
○Multiple fractures at birth & during childhood causing limb & spinal deformities
○Mosaic pattern to the bones (puzzle like pieces)
○Blue sclera of the eye
○Dental deformities
○Progressive hearing loss
● Treatment → NONE KNOWN, just focus on preventing &
treating fractures
○Prenatal US to detect disease in utero
○Growth hormone to stimulate bone growth
○Calcitonin to aid in bone healing
○Bisphosphonates to increase bone mass
○Surgery to correct fractures & place rods to correct deformities
○Physical Therapy & moderate exercise to increase bone density
● Nursing Care → provide a safe, protective environment to
minimize any trauma
○Educate parents on how to help kids live a productive, safe life
○Raise side rails up on cribs & beds to reduce falls
○Remove objects on the floor that could cause tripping
○ Lifting children with care → What special instruction
should you give to the parents? Reposition the child carefully
4. Meningitis → inflammation of the meninges due to either a
virus or bacteria
, ● Signs & Symptoms →
droplet precautions!
○High fever, chills, malaise (fatigue)
○Headache & vomiting
○Stiff neck (nuchal rigidity) & exaggerated deep tendon reflexes
○ Positive Brudzinski’s sign → flexion of the neck produces flexion of
the knees & hips
○ Positive Kernig’s sign → when patient lies with the hip flexed, the leg
cannot be completely extended without pain
○Photophobia
○ Skin lesions →
rash to ecchymosis
○Disorientation, confusion, delirium, deep stupor & coma
○Seizures & ICP, brain stem herniation & eventual death
● Diagnostic Tests → Lumbar puncture - CSF
will be cloudy
● Treatment → Antibiotics: PCNs, Cephalosporins &
Vancomycin with Rifampin
○Dexamethasone as adjunctive therapy with bacterial meningitis
4
○Supportive Care if viral
○Digoxin to control arrhythmias
○Mannitol to decrease cerebral edema
○ Anticonvulsant to treat seizures, Tylenol for HA & fever
○Vaccination as prophylaxis for high risk groups - college kids, military, travelers
● Nursing Care → assess patient’s neuro
status often!
○Monitor fluid balance carefully to avoid fluid overload - I’s & O’s!
○ Turn patient often to prevent joint stiffness & neck pain
○Quiet, comfortable, dark environment
○ Ensure that family members & others in contact are evaluated for post-
exposure antibiotic prophylaxis → What should the RN do first with a child
diagnosed with meningitis? Place on droplet precautions
5. Language Development → organized into
language milestones
● Neonate → cries when upset, makes enjoyment
sounds during meals
● 6 weeks → smiles to familiar voices,
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Cowell. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $17.99. You're not tied to anything after your purchase.
