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NURS 307 Final Study Guide, Study Guides, Projects, Research of Nursing

A.T. Still University of Health Sciences (ATSU)Nursing

NURS 307 Final Study GuideNURS 307 Final Study Guide

Typology: Study Guides, Projects, Research

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NURS 307 Final Study Guide
1. Bronchiolitis: most common cause: RSV
2. How is RSV transmitted?: -Transmitted predominantly through direct or
close contact with contaminated respiratory secretions
-Viable RSV live on environment surfaces for several hours and on hands for 30
minutes or more
3. Tonsillectomy care: -discourage from coughing frequently, clearing the
throat, blowing the nose
-ice collar
-pain meds at regular intervals
-tetracaine lollipops or ice pops, antiemetics, such as odansetron, or
scopolamine patch (ages 12+)
-cool water, crushed ice, flavored ice pops, or diluted fruit juice may be given
-avoid fluids with red or brown color
-suction equipment and oxygen should be available
4. Bronchiolitis symptoms: *fever
*cough
*rhinorrhea
*wheezing
-tachypnea or retractions
-apneic spells
-altered air exchange
-diminished breath sounds
5. RSV S/S: lethargy, poor feeding, irritability
6. Bronchiolitis: nursing care: -provide humidified oxygen
-suction nasopharynx
-encourage fluid intake
-contact and standard precautions
7. Bronchiolitis: preventative measure: -administer palivizumab (Synagis)
to high-risk infants
-given at onset of the RSV season and then monthly in an IM injection or IV
infusion for max of 5 doses
8. Candidates for Palivizumab (synagis): **prematurity, chronic lung, vent
depen- dent, muscular dystrophy
9. Foreign body airway obstruction: -small children (1-3 years) are prone to
put FBs into air passages (nose and mouth)
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NURS 307 Final Study Guide

  1. Bronchiolitis: most common cause: RSV
  2. How is RSV transmitted?: -Transmitted predominantly through direct or close contact with contaminated respiratory secretions -Viable RSV live on environment surfaces for several hours and on hands for 30 minutes or more
  3. Tonsillectomy care: -discourage from coughing frequently, clearing the throat, blowing the nose -ice collar -pain meds at regular intervals -tetracaine lollipops or ice pops, antiemetics, such as odansetron, or scopolamine patch (ages 12+) -cool water, crushed ice, flavored ice pops, or diluted fruit juice may be given -avoid fluids with red or brown color -suction equipment and oxygen should be available
  4. Bronchiolitis symptoms: *fever *cough *rhinorrhea *wheezing -tachypnea or retractions -apneic spells -altered air exchange -diminished breath sounds
  5. RSV S/S: lethargy, poor feeding, irritability
  6. Bronchiolitis: nursing care: -provide humidified oxygen -suction nasopharynx -encourage fluid intake -contact and standard precautions
  7. Bronchiolitis: preventative measure: -administer palivizumab (Synagis) to high-risk infants -given at onset of the RSV season and then monthly in an IM injection or IV infusion for max of 5 doses
  8. Candidates for Palivizumab (synagis): **prematurity, chronic lung, vent depen- dent, muscular dystrophy
  9. Foreign body airway obstruction: -small children (1-3 years) are prone to put FBs into air passages (nose and mouth)

-i.e. beads, toys, paper clips, small magnets, or food items which can be easily aspirated into the trachea

  1. Aspirated objects can obstruct the air passage, producing various changes including...: atelectasis, emphysema, inflammation, abscess
  2. FB in the air passage: S/S: choking, gagging, wheezing, or coughing **stridor, wheezing, sternal retraction, and cough (=most common)
  3. Foreign body airway obstruction: therapeutic management: - abdominal thrusts for children old than 1 year of age -chest thrust for children younger than 1 year old
  4. Diagnostic criteria for autism: -Two behavior domains: *difficulties in social communication and social interaction *unusually restricted, repetitive behaviors, interest, or activities
  5. Autism: Diagnostic Evaluation: -failure of social interaction and communica- tion development -significant GI symptoms (i.e. constipation) -communication impairment (any child who does not display language skills such as babbling or gesturing by 12 mths, single words by 16 mths, and two word phrases by 24 mths old)
  6. Obstructive sleep apnea syndrome is defined as:: disorder of breathing during sleep with prolonged partial upper airway obstruction and/or complete ob- struction that disrupts normal respiration during sleep and normal sleep patterns
  7. Common cause of obstructive sleep apnea: adenotonsillar hypertrophy
  8. Obstructive sleep apnea: common symptoms: -Nightly snoring -breathing pauses -choking or gasping on arousal -disturbed sleep patterns -secondary enuresis -daytime sleepiness -daytime neurobehavioral problems
  9. OSA: TX: Adenotonsillectomy, CPAP, BiPAP (cycles between high and low pres- sure)
  10. Diagnosis is made by:: An overnight sleep study (polysomnography), which provides evidence of sleep disturbance, respiratory pauses, and changes in oxy- genation
  • Fever -Roth Spots -Olser Nodes
  • Murmur -Janeway lesions
  • Anemia -Nail-bed hemorrhage
  • Emboli
  1. Infective endocarditis: TX: -high dose of antibiotics IV for 2 to 8 weeks
  2. Infective endocarditis: Prevention: admin of prophylactic abx therapy to high risk pts prior to dental procedures (1 hr before procedure)
  3. Pulmonary HTN is defined by a:: mPAP of 25 mmHg or greater in children older than 3 mths of age
  4. Pulmonary HTN: 3 causes: 1) increased pulm venous pressure (i.e. mitral stenosis, left ventricle noncompliance)
  1. post-tricuspid cardiac shunts (i.e. large VSD, large PDA)
  2. small pulmonary arteries
  1. Pulmonary artery hypertension: S/S: -dyspnea with or w/out exercise (most common) -chest pain (coronary ischemia in RV from hypertrophy) -syncope (r/t decreased CO) -RS heart dysfunction (venous congestions & edema) = poor prognosis
  2. Pulmonary artery hypertension: education: -exercise prescriptions are spe- cific to each pt -pts should avoid high altitudes bc of the relative hypoxia -use of anticoagulants -digoxin & diuretics for RS HF
  3. Pulmonary artery hypertension: prostacyclin infusion education: - cannot be interrupted - can cause HTN crisis -have back up systems in place -preparation of infusion/use of equipment & maintaining sterility of central line
  4. Patients with pulmonary artery hypertension are at risk for:: thromboembol- ic events
  5. Carditis: S/S: -symptom of Rheumatic fever -tachycardia out of proportion to degree of fever
  • cardiomegaly -new murmurs or change in preexisting one

-muffled heart sounds -pericardial friction rub

pressure RA -left to right shunt

  1. ASD is what type of defect?: -acyanotic, increases pulmonary BF
  1. ASD: Patho: Bc left atrial pressure slightly exceeds right atrial pressure, blood flows from the left to the right atrium causing an increased flow of oxygenated blood into the right side of the heart
  2. ASD: S/S: -May be asymp -Murmur* (systolic murmur with wide fixed splitting of S2)
  • HF
  1. ASD: complications: -atrial dysrhythmias -pulmonary vascular obstructive disease -emboli formation
  2. Immunizations:
  3. Labs to indicate sepsis: -cultures of blood, urine, and CSF -CRP, serum amyloid A, procalcitonin, interleukin- 6
  4. Sepsis: blood studies show signs of:: anemia, leukocytosis, or leukopenia -an elevated number of immature neutrophils (a left shift), decreased or increased total neutrophils, and changes in neutrophil morphology
  5. Cyanotic Congenital Heart Diseases: -Pulmonary atresia -Tricuspid atresia -Tetralogy of fallot (TOF)
  6. Manifestations of cyanotic defects: -poor feeding
  • murmur -poor weight gain/FTT -delayed cap refill
  • polycythemia** -cyanosis (DESAT)** -RIGHT TO LEFT SHUNT
  1. Encopresis is defined as: repeated bowel movements into bed or clothing at least 1x per month for a period of at least 3 months, is not due to a physiologic condition or substance, and occurs in individual who is at least 4 years of age
  2. Encopresis with constipation and overflow incontinence: requires the pas- sage of stool less than 3x per week
  3. Encopresis without constipation and overflow incontinence: where there is no evidence on physical examination or by history of constipation and soiling is no more than intermittent
  4. Most common cause of encopresis: CONSTIPATION which may be precipitat- ed by environmental change, such as having a new sibling, moving
  • probiotics -magnesium hydroxide
  1. Encopresis: Interventions: -bowel retraining with mineral oil, a high fiber diet, and a regular toileting routine (toileting routine - child sitting on toilet 10 to 15 mins after meals for intervals of ten mins)
  2. Ostomies care/management: -drawing a picture with a stoma and explaining it as another opening where bowel movements come out -doll to demonstrate the process -one piece outfits (keep hands away from pouch & loose waist avoids pressure on appliance) -keep child occupied during pouch change -avoid small clips and rubber bands to prevent choking in small children
  3. In infants with colostomy left unpouched:: -protect skin with barrier sub- stance (zinc/stoma powder) -can apply zinc based products over topical antifungal and antibacterial agents if infection is present)
  4. ulcerative colitis (UC) is a: type of inflammatory bowel disease that is limited to the colon and rectum
  5. ulcerative colitis (UC): S/S: -onset insidious - diarrhea, possibly with hema- tochezia, and usually w/out fever or wt loss -severe = freq bloody stools, abdominal pain, significant anemia, fever, and wt loss
  6. ulcerative colitis: nutritional support: -high protein, high calorie -supplementation with multivitamins, iron, and folic acid
  7. ulcerative colitis: educate on...: drug therapy even when remission symptoms present
  8. Guidelines of managing diarrhea: -assessment of fluid and electrolyte imbal- ance
  • rehydration -maintenance fluid therapy -reintroduction of an adequate diet -treat first with oral rehydration therapy
  1. Oral rehydration solutions enhance and promote the:: reabsorption of sodi- um and water
  2. Volvulus: the intestine twisting around itself, compromises the blood

supply which results in intestinal necrosis, peritonitis, and death

  1. Malrotation is caused by:: abnormal rotation of the intestine around the supe- rior mesenteric artery during embryologic development -most serious type because if the intestine undergoes complete volvulus

-position supine or on side

-measure abdominal girth -measure residual gastric contents before feeding and listen for bowel sounds

  1. Growth hormone (GH):
  2. Diabetic ketoacidosis (DKA): what should you monitor for?: Monitor for cardiac arrhythmias, because they more than likely have hypokalemia
  3. Diabetic ketoacidosis (DKA): S/S: - dehydration* -mental confusion* -fruity breath* -electrolyte imbalances
  • acidosis -deep, rapid breathing (Kussmaul)
  • coma
  1. Pressure ulcers and prevention: -assess skin head to toe -turning q2 hours -use pillows, blanket rolls, and positioning devices -use draw sheets to minimize shear -use pressure reduction surfaces -allow moisture reduction by using dry weave diapers and disposable under pads -use skin moisturizers -conduct nutrition consults
  2. Fractures in children:
  3. evidence of a fractured clavicle: -unilateral moro reflex or at the 2- week well-child visit, when a fracture callus is palpated on the infant's healing clavicle
  4. Down syndrome manifestations: -protruding abdomen -broad, short feet and hands
  • hypotonia
  1. Risk factor: Glomerulonephritis: -recent group A beta-hemolytic streptococcal infection
  2. Glomerulonephritis: S/S: -cloudy tea colored urine -edema (periorbital, facial)*
  • anorexia -reduced UO
  • HTN*
  • lethargy
  • irritability
  • proteinuria
  1. Piaget's cognitive stage of formal operations: -11 to 15 years old -adaptability and flexibility -adolescents can think in abstract terms, use abstract symbols, and draw logical conclusions from a set of observations
  2. Piagets: first year of life: sensorimotor (birth to 24 mths)
  3. Play in school age children: -associative play (group play in similar or identical activities but without rigid organization or rules) -imitative, imaginative, dramatic play
  4. Freud's stages: -Oral (birth to 1 year) -Anal (1 to 3 years) -Phallic (3 to 6 years) -Latency period (6 to 12) -Genital stage (12 years and older)
  5. Motor growth and development for child (1 to 2 years old, 5 months and 8 months):
  6. Motor skills: 1 to 2 years old: 12-13 mths: walk alone using a wide stance for extra balance 18 mths: try to run but fall easily 2 years: they can walk up and down stairs
  7. Gross motor skills: 5 mths: -can turn from abdomen to back -when supine puts feet to mouth
  8. Fine motor skills: 5 mths:
  9. Erikson's theories: -Trust vs mistrust (0-1) -Autonomy vs shame doubt (1-3) -Initiative vs guilt (3-6) -Industry vs inferiority (6-12) -Identity vs role confusion (12-18)
  10. Evidence-based practice (EBP) definition:: is the collection, interpretation, and integration of valid, important, and applicable patient- reported, nurse observed, and research-derived information
  11. Gestational diabetes: Complications during delivery: -shoulder dystocia -respiratory distress -macrosomnia, but not premature delivery
  12. Allergic reaction: careful observation with IV iron administration is required bc of risk of anaphylaxis, so a test dose is recommended
  13. Hematopoiesis: formation of blood cellular components; produced in the bone marrow

*production of RBCs occurs in the embryo by the 2nd week of gestation

  1. Children with bottle mouth caries:

by ischemia

  1. Iron deficiency anemia:
  1. Leukemia is an:: unrestricted proliferation of immature WBCs in the blood-forming tissues of the body -no "tumor" is present but the same neoplastic properties are seen in solid cancers
  2. Leukemia: which organs are most severely affected: -liver and spleen
  3. Leukemia: destruction takes place by...: infiltration and subsequent compe- tition for metabolic components
  4. Leukemia: S/S early in the disease: -petechial hemorrhages -wt loss -bruising without a cause -joint pain
  5. Leukemia: Consequences: -Anemia from decreased RBCs -Infection from neutropenia -Bleeding tendencies from decreased platelet production -Spleen, liver, and lymph glands show marked infiltration, enlargement, and fibrosis
  6. Wilm's tumor: Manifestations: -usually asymp than the mass -form, lobated mass on one side or midline of the abdomen -if symptomatic HTN (caused by secretion of excess amounts of renin), abdominal pain, and/or hematuria
  7. Wilm's tumor: 2 staging systems: -favorable histology -anaplastic (unfavorable) histology
  8. Ewing sarcoma originates in:: the shaft of long and trunk bones, mostly affecting the pelvis, femur, tibia, fibula, humerus, ulna, vertebra, scapula, ribs, and skull
  9. Unlike osteosacoma, Ewing sarcoma peak incidence is:: 5-30 years, not during years of rapid growth -appears in the marrow spaces of the bone
  10. Ewing sarcoma: manifestations: -deep bone pain
  • swelling
  • fever
  1. Ewing sarcoma: nursing care management: -child should wear loose- fitting clothes -increased sensitivity, the area should be protected from sunlight and sudden changes in temp -encourage child to use extremity as tolerated -the drug regimen usually results in hair loss, severe nausea, vomiting,