113

theophyline >20 BUN >20 US values

BP during ICP keep BP above 170, issues at 222!
Guaifenesin (Robitussin) is an expectorant that reduces the viscosity of thick secretions by increasing
respiratory tract fluid; drinking a full glass of water after taking the medication is recommended.
Pupils norm 3-5mm
Chest tube >100ml HCP
The combination of excessive alcohol ingestion and the benzodiazepine alprazolam (Xanax) causes
respiratory depression, which leads to alveolar hypoventilation secondary to carbon dioxide retention, and
respiratory acidosis. Therefore, clients should be advised not to take multiple substances that increase
the risk of respiratory depression (eg, opioids, benzodiazepines, alcohol, sedating antihistamines).
<10 kicks in 2hrs = HCP
Fetal >160HR >10min = HCP
Hyperemesis gravidarum = ketone uria,
x pril, sartan, ibuprofen in preganancy
Folic acid - leafy greens, toms, rice, liver, beans, cereal, green veg
Lab values in 3rd tri = 5000-15000WBC,
12wks - gender, doppler
20wks - fetoscope
MAP = sys+(dys x2)/3 >60, 70-105norm
goal is to decrease no more than 25%
Presumptive (subjective) probable (objective) diagnostic(positive)
RUQ pain = HELLP
fetal movement felt at 18-20wks
Weight gain <18=35lb, 18-25=30lb, 25-30=20lb, >30=15lb all lb are + or - 5lb
Magnesium sulphate therapeutic level = 2-3.5
pril and sartan avoided in preganacy
white vag discharge good in preganacy, clear bad
magnesium toxicity = dtrs, <30ml pee, resp depression
preg hemoglobin >110 if <90 = anemia
Triage - Red = Priority pt who will survive, Yellow = wait 1-2hrs, green = wait for hours (walking wounded),
Black = will not survive
DKA = >14, HH = >33
malignent hyperthermia - tachy pnea (hypercapnia), tachycardia,stiff muscles (jaw and extremities),
hyperthermia - Caused by anthesia Succinylcholine Antidote is Dantrolene
Barotrauma - PEEP to high - damages lungs
Antropine - Anticholinergic, increases Heart rate
Infant resps 30-60 norm, pee 2ml/kg/hr norm
Alcohol = Hypoglycemia
ADHD = lifelong,
PTSD = aggressive and anger
Severea anorexia nervosa = develop lanugo
Memantine = used for Alzheimer disease
Magnesium serum level = 0.75-1.25norm mmol/L
SYstemic Analgesia can be given only during active phase of labor
Start CPR on newborn with HR<60, as norm is 100-160
postpartnum mum WBC can reach 30000 norm, temp norm upto 38,
etopic pregnancy - pain radiates to shoulder
Molar pregnancy - fetus grows as cluster of cells and is dead, produces brown liquid out of vagina
Neonate expected findings = 2 arties and one vein in umbilical, plantar folds, desquamation of feet, Head
32-37cm, no jaundice for 24hrs, no nasal flare, should void in first 24hrs
extrophy of the bladder = cover in film
Anencephaly - no brain developed=dead baby
green amniotic fluid = meconium = possible emergency
Bishop score >8 = labor induction will be successful (measures consistency, position, dialation,
effectment, station)
Norms at birth - >2.2 blood glucose, resp 30-60,
down syndrome signs - flat crease on hand, flat nose, protruding tongue, hypotonia, low ears

"back labor" occures with baby in Right Ocipital Posterior (head down, arse facing back to the right) - place
pt on all fours, push on lower right area of the back as counter pressure
Right occipital anterior (head first, face pointing to the back) - best position for birth
apgar 7-10 is good
contractions bad signs = lasting >90sec, occur <2mins apart, strength >80mmhg, rest >20mmhg
placenta accreta - placenta stuck in uterus wall - emergency surgery to remove- risk for hemmorrage
oxytocin checks before enducment - i/o (antidiuretic), dialation, VS, contraction, FHR
Edwards syndrome = dead baby in a few weeks after birth
after circumcision - yellow exudate is normal, minimal bleeding, pee as normal
cephalexin - allergy to penecillin means allergic to this drug as well
hematocrit 40-50%, hemoglobin 132-173, inr 0.75-1.25
INR - guages warfarin theraputic level is 2-3 times, should not be higher than 4
Fire = rescue, alarm, confine, extinguish RACE
azithiopine - immunosupressant
carbidopa and levodopa (-dopa) are antiparkinson drugs - increase risk for falls as make dizzy, ortho HTN
restraints - check circulation qh
clopidogrel (plavix) - blood thinner, discontinue 5-7 days before surgery
Naproxen - is an NSAid and should be stopped 7 days before surgery
shingles - air and contact precautions
creatineine 53-115
surgery requires platlet count >100,000
Pulsus paradoxus - korotkoff sound, should be <10mmhg
Gastric ph norm is <5
Norepinephrine - can cause vasoconstriction and extravastion - it's antidote is phentolamine and is a
vasodialtor
prasugrel, clopidogrel, ticagrelor (GREL) - antiplatlet drugs should be 5-7 day gap between surgery
18 guage catheter for administering blood is prefered
Flumazenil is antidote for benzodiazapine
s3 - heart failure or fluid overload
diphenhydramine (antihistamine) - causes anticholinergc respnse- urinary retention
Infectious mononucleosis is caused by the Epstein-Barr virus. Spleen rupture is a serious complication of
infectious mononucleosis that can occur spontaneously and present with sudden onset of left upper
quadrant abdominal pain. The 16-year-old client should be taken to the emergency department for close
monitoring of hemoglobin levels, supportive care to prevent hemorrhagic shock, and possible surgery.
A reduction or energy expenditure of 3500 calories (kcal) will result in a weight loss of 1 lb.
Ejection fraction is most commonly measured using echocardiography. This non-invasive technique
provides good estimates of end-diastolic (EDV) and end-systolic volumes (ESV), and stroke volume (SV =
EDV-ESV). Normally, EF is >60%. For example, if the SV is 75 ml and the EDV is 120 ml, then the EF is
63%.
Asthma perakflow - Green >80%=good, Yellow 50-80%=caution, Red <50%=emergency
Retinoblastoma (tumor) - check for absence of red reflex - also found with cataract
Ventricular bigeminy is a rhythm in which every other heartbeat is a premature ventricular contraction
(PVC). PVCs in the presence of a myocardial infarction (MI) indicate ventricular irritability and increase the
risk for a more serious dysrhythmia - HCP
Hemophilia - give meds subcutaenous and not mucsle, apply pressure 5min,
Kawasaki disease - is inflammation of artery walls - give immuglobin to prevent heart disease - can lead to
gallop heart rate and decreased urine leading to pulmonary edema
Tetralogy of Fallot - murmur, 65-85% o2 norm, low weight - place in knee to chest position to aid low o2
patent ductus arteriosus = loud machine like murmur
ventricular septal defect = sweaty and tachypnea are signs of HF
coarctation of the aorta = weak pulses in lower extremities
Hirschsprung disease - diminished ability to poo, warning if foul smelling diahrea and fever = enterocolitis
Autism kids - keep in private room far from nurses station, siblings often have it
tonsilectomy - bedrest for 14 days, or risk of bleeding

School age = give homework (Industry), adolescents = friends visit

Tooth eruption is variable, but it starts with the lower central incisors usually between age 6-10 months.
The following is a quick assessment formula to calculate the expected number of teeth during the first 24
months:
Age of child (in months) 6 = Expected number of teeth
A 12-month-old should have approximately 6 teeth, and by age 30 months all primary teeth (20) should
have erupted.
Infants grow rapidly and by age 12 months, the head and chest circumference are equal. The infant
should weigh approximately 21.5 lb (9.75 kg), which is triple the birth weight. The infant should also
be able to sit down from a standing position without assistance.
4 year old hop on one foot, draw a square, catch a ball 50% of time
Chest circumference exceeds abdominal circumference after age 2, resulting in a taller and more slender
appearance.
8-10mths develop pincer grip
If given antibiotics, replace toothbrush as it can harbor infection being treated
Somnolence = drowsy = so NPO
Meningitis droplet precaution
Botulism = lead to resp emergency
Growth hormone replace=daily injection
Ringworm is a fungal infection, does not involve a worm

Fifth disease ("slapped face," or erythema infectiosum) Children with fifth disease are communicable
only prior to onset of symptoms (eg, rash, joint pains). The causative agent, human parvovirus, spreads
via respiratory secretions. Fifth disease is self-limiting and short-lived; treatment is given to alleviate
symptoms. Isolation is not usually required for a non-hospitalized child.

Reyes syndrome aspirin and Viral infection (flu) are major causes

Preschoolers imaginative play like puppets

Trismus (inability to open the mouth due to a tonic contraction of the muscles used for chewing) may
indicate a more serious complication of tonsillitis, a peritonsillar or retropharyngeal
abscess(collection of pus). Other features include a "hot potato" or muffled voice, pooling of saliva, and
deviation of the uvula to one side. This abscess can occlude the airway, making it a medical emergency.
Surgical intervention (tonsillectomy or incision and drainage) is often required. In the meantime,
maintaining an adequate airway is essential.

Silent chest - Inability to hear any breath sounds or wheezing in an acute asthma client ("silent chest") is
an ominous sign and requires emergency intervention.

Neonatal abstinence syndrome (drugs) affects the autonomic nervous system (stuffy nose, frequent
yawning), gastrointestinal tract (poor feeding, diarrhea), and central nervous system (irritability,
restlessness, high-pitched cry).
Meconium ileus is classic for cystic fibrosis, a genetic disorder. Floppy muscle tone is typical for Down's
syndrome, a genetic disorder.
Epiglottitis (eg, stridor, temp, tachycardia, tachypnea, acutely ill, drooling, leaning forward, dyspnea), the
nurse should prepare for an emergency airway (intubation). Illness is often triggered by Flu, so
immunisation will protect
A ventriculoperitoneal shunt is used to treat hydrocephalus. Complications include blockage (with signs of
increased intracranial pressure [ICP]) and infection. The normal pulse range for a 1-year-old is 100160/min; bradycardia can be a sign of increased ICP.
Nephrotic syndrome is a collection of symptoms resulting from glomerular injury. The 4 characteristic
manifestations are proteinuria (increased permability), edema, hypoalbuminemia (albumin norm 35-50),
and hyperlipidemia (cholesterol norm 5.2).
Acute glomerulonephritis = check BP
Otis media symptoms should clear after 72hrs on antibiotics otherwise return to DR
Bacterial meningitis give antibiotics asap to reduce ICP
Hemolytic uremic syndrome (HUS) is a life-threatening complication of Escherichia coli diarrhea and
results in red cell hemolysis, low platelets, and acute kidney injury. Hemolysis results in anemia, and low
platelets manifest as petechiae or purpura.
Hip dysplasia = extra gluteal folds = to prevent keep legs flexed and abducted
Status epilepticus = antidote is benzodiazepines pam/lam

Paroxysms of rapid coughing that lead to vomiting are a key feature of pertussis infection. Pertussis
is a highly contagious disease and requires droplet precautions. It can be deadly if contracted in infancy
before vaccination is started. This client should be placed in isolation immediately to prevent the spread
of disease.

Wilms tumor do not palpate

Green vomit = bowel obstruction = HCP Emergency

Pediatric asthma can present as night coughing until the child vomits.

S3 normal in children

Infants can not shiver

Pain, limited range of motion, and fever indicate joint infection (septic joint). A septic hip is a surgical
emergency as impaired blood supply may lead to permanent joint destruction, sepsis, and/or death. The
nurse should expect management to include cultures, antibiotics, and surgical debridement.