Pediatric Nursing

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Jesfin Joseph

Pediatric Week 6 Unit 4d; Chapters 19, 20, 21, and 22
Chapter 19 Hematologic, Immunologic, and Neoplastic Disorders
Classroom prep;
Review chapter
Review patho
Answer questions at the end of the chapter in full sentences; 1, 6, 8, and 9
1. The most frequently reported initial concern of the caregiver for a child with a
Wilms’ tumor is abdominal mass noticed during removing of clothes.
6. A condition in which the normal hemoglobin is partially or completely replaced by
abnormal hemoglobin is Sickle cell anemia.
8. The nurse is talking to an adolescent who is concerned about hair loss secondary
to radiation for non-Hodgkin’s lymphoma. The most appropriate response to the
adolescent is asking the adolescent “What do you know about the effects of
radiation and your hair growing back?”
9. A child with sickle cell anemia comes to the emergency department with a
complaint of joint pain after playing games at school. The priority nursing
intervention will be to Check the pulse oximeter reading .

Sickle Cell Crisis
Vaso-Occlusive Crisis




Caused by stasis of blood with clumping of cells in the microcirculation leading
to ischemia, and infarction
Manifestations: Fever; painful swelling of hands, feet, and joints; and abdominal
pain

Splenic Sequestration




Caused by pooling and clumping of blood in the spleen (hyperspleenism)
Manifestations: Profound anemia, hypovolemia, and shock

Aplastic Crisis




Caused by diminished production and increased destruction of red blood cells,
triggered by viral infection or depletion of folic acid
Manifestation: Profound anemia and pallor

Chapter 20 Musculoskeletal Disorders

Jesfin Joseph
Classroom prep;
Review chapter
Review patho
Define the following Key Terms;




PRICE- Protect, Rest Ice, Compression, and Elevation
Molding- refers to when in utero forces causes positional deformities.
Dysplasia- the enlargement of an organ or tissue by the proliferation of cells
of an abnormal type, as a developmental disorder or an early stage in the
development of cancer.
Galeazzi sign- uneven heights in bent-knee position
5 p’s for potential vascular compromiseo Pain
o Pulse
o Pallor
o Paresthesia
o Paralysis




********************Nursing
Alert************************
Fractures in infancy are generally rare and warrant further
investigation to rule out the possibility of child abuse and to
recognize bone structure defects.

Assessment Findings: Juvenile Idiopathic
Arthritis





Stiffness, swelling, and limited motion occur in affected joints.
Affected joints are warm to touch, tender, and painful.
Joint stiffness is present on arising in the morning and after
inactivity.
Uveitis (inflammation of structures in the uveal tract) can occur and
cause blindness.

Chapter 21 Dermatologic Diseases
Classroom prep;
Review chapter

Jesfin Joseph
Review patho
Answer questions in the back of the chapter in full sentences; 1, 5, and 6
1. A 7-year-old come sin to the clinic with impetigo around his mouth and nose. The
statement that would indicate to the nurse that the caregiver understands the
child’s home care instructions is “After 2 days on antibiotic treatment, he can
return to school.”
5. An adolescent has been admitted to the hospital with cellulitis on the lower leg.
The nurse would identify an increasing area of pain and redness as consistent
with the admitting diagnosis.
6. A child has received an anti-lice shampoo treatment after lice were found at
school. The nurse’s teaching plan should reinforce that the shampoo treatment
should be repeated in 1 week.
************Priority Nursing
Actions****************
Actions to Take in the Event of a Major
Burn Injury








Stop the burning process
Assess the ABC’s
Begin resuscitation if child is not
breathing
Remove burned clothing and jewelry
Cover wound(s) with clean cloth
Keep the child warm
Transport the child to the emergency
room

To determine adequacy of fluid
resuscitation, vital signs (especially
heart rate), urine output, adequacy
of capillary filling, and sensorium
status are assessed
Chapter 22 Communicable Diseases
Classroom prep;
Review chapter
Review patho

Jesfin Joseph
Answer in full sentences the questions in the back of the chapter; 1, 2, 3, and 9
1. A 3-year-old child with chickenpox is placed on Tylenol as needed for fever. If the
caregiver says “I can give baby aspirin instead of Tylenol” it would indicate to
the nurse that he or she needs further instructions.
2. If the caregiver of a 1-year-old child states, “my child cannot have the
influenza immunization because he is allergic to eggs” it would indicate to
the nurse that the caregiver understands the criteria for administering the influenza
immunization.
3. The nurse is teaching the caregiver of an infant about the Hib immunization. if
the caregiver state “ my child will need a booster before he goes to
kindergarten” it would indicate to the nurse that the caregiver needs further
instructions.

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