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NR 328 FINAL EXAM STUDY GUIDE 3 VERSIONS / NR328 FINAL EXAM STUDY GUIDE 3 VERSIONS: CHAMBERLAIN COLLEGE OF NURSING - LATEST, A COMPLETE DOCUMENT FOR EXAM $18.49   Add to cart
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NR 328 FINAL EXAM STUDY GUIDE 3 VERSIONS / NR328 FINAL EXAM STUDY GUIDE 3 VERSIONS: CHAMBERLAIN COLLEGE OF NURSING - LATEST, A COMPLETE DOCUMENT FOR EXAM
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NR 328 FINAL EXAM STUDY GUIDE 3 VERSIONS / NR328 FINAL EXAM STUDY GUIDE 3 VERSIONS: CHAMBERLAIN COLLEGE OF NURSING - LATEST, A COMPLETE DOCUMENT FOR EXAMNR 328 FINAL EXAM STUDY GUIDE 3 VERSIONS / NR328 FINAL EXAM STUDY GUIDE 3 VERSIONS: CHAMBERLAIN COLLEGE OF NURSING - LATEST, A COMPLETE DOCUMENT F...

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  • May 6, 2022
  • 16
  • 2021/2022
  • Other
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  • nr 328
  • nr 328 final exam study guide 3 versions

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  • CHAMBERLAIN COLLEGE OF NURSING
  • NR 328 (NR328)
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VERSION 1
NR 328 FINAL EXAM STUDY GUIDE
Rubeola (measles)
 A highly contagious viral disease that can lead to neurological problems and death
 Direct contact with droplets from an infected person
 Contagious mainly during prodromal period (Prodromal CHARATERISTICS: fever, and upper
respiratory inections)
 S/S: photophobia; Koplik spots on buccal mucosa; confluent rash that beings ON THE FACE and
SPREADS DOWNWARD
Varicella (chickenpox)
 Viral disease characterized by skin lesions
 Lesions begin ON THE TRUNK and SPREAD to FACE and PROXIMAL EXTREMETIES
 Progresses through macular, popular, vesicular, and pustular stages
 Transmitted by direct contact, droplet spread, or freshly contaminated objects
 Communicable prodromal period to the time all lesions have crusted
Pertussis (whooping cough)
 Acute infectious respiratory disease, usually occurring in infancy
 Cause by gram (-) bacillus
 Begins with Upper Respiratory symptoms
 Paroxysmal stage characterized by prolonged coughing and crowing or whooping UPON
INSPIRATION; lasts 4-6 weeks
 Transmitted by direct contact, droplet spread or freshly contaminated objects
 Treated by administering erythromycin
 Complications: pneumonia, hemorrhage, and seizures
Rubella (German measles)
 Common viral disease
 Has teratogenic effect on fetus during first trimester
 Transmitted by droplet and direct contact with infected person
 Discrete red maculopapular rash that STARTS ONE THE FACE and RAPIDLY SPREADS TO
ENTIRE BODY
 Rash disappears within 3 days
Parmyxovirus (mumps)
 Incubatoin: 14 to 21 days
 S/S: fever, headache, malaise, parotid gland swelling and tenderness; manifestations include
submaxillary and sublingual infection, orchitis, and meningoencephalitis
 Transmitted via direct contact or droplet spread
 Analgesics used for pain and antiseptics for fever
 Bed rest maintained until swelling subsides
MMR Vaccine
 Generally administered between 12-15 months and repeated at 4-6 years or by 11-12 years
 In times of measles epidemic it is possible to give measles vaccine at 6 months and repeat MMR at
15 months
 Measles vaccine is contraindicated in individuals with history of anaphylactic reaction to
neomycin or eggs, those with altered immunodeficiency, pregnant women
 May be given to those with HIV and breastfeeding women
 Administer SUB-Q at separate sites
 Children may have a light, transient rash for 2 weeks after administration of vaccine
DTaP Vaccine

,  Beginning at 2 months, administer 3 doses at 2 month intervals
 Booster doses given at 15 to 18 months and 4 to 6 years
 IM
 Not given to children past 7th birthday; they would receive Td, which contains full strength
protection against tetanus and lesser strength iphtheria protection
 Contraindication for pertussis vaccine: encephalopathy within 7 days of previous dose of DTaP;
history of seizures; neurological symptoms after receiving the vaccine; systemic allergic reactions
to the vaccine
 Parents should be instructed to start acetaminophen administration after immunization (normal
dose 10 to 15 mg/kg)
 Immediately report any side effects of immunization to PCP
HiB (Haemophilus influenzae type B) Vaccine
 Offers protection against epiglottitis, bacterial meningitis, septic arthritis
 IM
 No contraindications
 Vaccines have different series administration schedules; schedules cover children through age 5
Hepatitis B Vaccine
 May be given to newborns prior to hospital discharge
 All children up to 18 years should be vaccinated
 Contraindicated in individuals with anaphylactic reaction to common Baker’s yeast
Varicella Vaccine
 Protection from chickenpox
 Usually a school requirement
 Is safe for children with asymptomatic HIV
 Administer at 12 to 18 months
 Give MMR and varicella on same day or >30 days apart (separate site)
Nursing Care for Children with Communicable Diseases
 Isolate child for period of communicability
 Treat fever with NONASPIRIN products
 Report occurrence to health department
 Prevent child from scratching skin (cut nails, mittens, provide soothing baths, etc.)
 Administer diphenhydramine HCl (Benadryl) as prescribed
 WASH HANDS
Diarrhea
 Increased number or decreased consistency of stool
 Can be serious of fatal illness, especially in infants
 Causes: bacterial, viral, parasitic; mal-absorption problems; inflammatory diseases; dietary factors
 Conditions Associated with Diarrhea: dehydration; metabolic acidosis; shock
Diarrhea: Nursing Assessment
 Usually occurs in infants
 History of exposure to pathogens, contaminated food, dietary changes
Signs of Dehydration
 Poor skin turgor
 Absence of tears
 Dry mucous membranes
 Weight loss (5 – 15 %)
 Depressed fontanels
 Decreased urinary output, increased specific gravity
Lab signs of Metabolic Acidosis
 Loss of bicarbonate (serum pH <7.35)

,  Loss of sodium and potassium through stools
 Elevated hematocrit (Hct)
 Elevated BUN
Signs of Shock
 Decreased blood pressure
 Rapid, weak pulse
 Mottled gray skin color
 Changes in mental status
Diarrhea: Nursing Plan and Intervention
 Assess hydration and vital signs frequently
 Monitor I&Os
 Do NOT take temperature rectally
 Rehydrate as prescribed with fluids and electrolytes
 Add potassium to IV fluids ONLY with adequate urine output
 Calculate IV hydration to include maintenance and rehydration fluids
 Collect specimen to aid in diagnosis of cause
 Check stool pH, glucose and blood
 Check urine specific gravity
 Institute careful Isolation precautions; wash hands
Teach Home care for child with diarrhea
 Provide child with oral rehydration solution such as Pedialyte or Lytren
 Child may temporarily need lactose-free diet
 Child should NOT receive anti-diarrheals (i.e. Immodium A-D)
 Do not give child grape juice, orange juice, apple juice, cola or ginger ale. These solutions have
high osmolality
BURNS
 Tissue injury caused by heat, electricity, chemicals, or radiation
 Burns are 2nd major cause of accidental deaths in children > 15 years
 Children younger than 2 years have higher mortality rate due to: greater central body
surface area, greater part of body surface area is centered in head and trunk; Greater fluid
volume (proportionate to body size); Less effective cardiovascular responses to fluid volume
shifts
 In children, partial thickness burn is considered a major burn if it involves more than 25% of body
surface
 Full thickness is considered major if it involves more than 10% of body surface
 Rules of 9 cannot be used bc of changing proportions of children
 Assessment for Children with burns: Lund-Browder Chart: which takes into account the
changing proportions of the child
 Fluids need to be calculated from the time of the burn
 Parkland Formula is commonly used as a guideline for calculating fluid replacement and
maintenance: it is based on the child’s body surface area and should include volume for burn
losses and maintenance
 Adequacey for evaluating fluid replacement is determined by evaluating Urinary Output
(urinary output in infants and children should be 1-2mL/kg/hr)
 Specific gravity should be less than 1.025
Types
1. Obstructive: Cystic fibrosis; Bronchiolitis; Asthma; Epiglottitis; Croup
2. Infective: RSV; Tonsillitis; Otitis Media
Important signs in Children
 Carinal signs of Respiratory distress: restlessness; increased respiratory rate; increased pulse
rate; diaphoresis

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