Explorez tous les épisodes du podcast Nursing School - Audio Review

1.     Identify and describe nursing care related to seizures.

• Obtaining history from patient/family

- Type of seizure

- Manifestations

- Duration

- Management

• Maintaining safety

- Seizure precautions

- Ensuring compliance with drug therapy

• Observations and nursing care during a seizure

• Health promotion for families

2.     Define “status epilepticus” and describe related problems.

1.     Describe classification of seizures.

Focal, generalized, and unknown onset

2.     Describe how seizures are diagnosed.

• Patient/family history
• Complete physical and neurological examination
• Electroencephalogram (EEG)
• Laboratory and neuroimaging tests

3.     Describe the treatment of seizures.

• Holistic approach

• Medications

• Ketogenic diet

• Vagal nerve stimulation

• Surgery

1.     Recall the nutritional requirements of children and adolescents.

• toddler and preschool
• school age
• adolescent

2.     Identify factors that can influence nutritional intake for children and adolescents.

• Weight and height progression
• Growth and developmental stage
• Illness and disease
• Physical activity level
• Media influences

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6. Describe the nurse’s role in preventing childhood injuries.

Model safety practices • Educate parents and children •Support legislative efforts that advocate prevention • Collaborate with other health care providers to promote safety and injury prevention

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 5. Define Sudden Infant Death Syndrome (SIDS) and list the possible risk factors related to its occurrence.

Risk factors related to sleeping position • Parental smoking, avoiding overheating, encouraging breastfeeding, etc.

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4. Define Shaken Baby Syndrome (SBS) and list the possible signs associated with SBS.

Definition, signs of SBS and strategies to prevent SBS •Strategies to reduce incidences of SBS (e.g. Period of Purple Crying program)

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 3. Apply strategies that can be applied to prevent childhood injuries and identify the teaching needs for children and/or their families that promote safety.

•Anticipatory safety guidance

• Passive vs. active strategies

• Three Es: • Education • Engineering • Enforcement (legislation)

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2. Identify the leading causes or trends associated with unintentional pediatric injuries.

Epidemiological approach to unintentional injuries.

• Injury trends and causes related to growth & development (host), season, environment and physical and social agents (e.g. may include choking & suffocation, falls (I.e. crib safety), accidental poisoning, motor vehicle incidents (I.e. pedestrian &car safety), drowning, incidents related to sports & recreation; head injuries; burns and scalds

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Understand the connection between the developmental stage of a child and the type of injury they have.

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1.    Describe age-appropriate non- pharmacological interventions for controlling pain in children.

a.      Trusting relationship • Distraction-Play • Massage • Application of heat/cold • Music •Visualization • Positive self-talk • Role of Child Life Therapist in hospitals

2.    Describe documentation of nursing assessments and interventions for pain.

a.      Document nursing assessment and pain management

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1.    Describe pain assessment for pain in children (the 5th vital sign)

a.     Pediatric pain assessment tools • Obtain a pain experience history •

2.    Describe pharmacologic interventions, management modalities and administration routes (and/or delivery devices) for controlling pain in children.

a.     • Opioids/patient-controlled analgesia • NSAIDS • Non-opioids • Adjuvants

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3.     Identify the therapeutic and adverse effects of medications used in high-risk pregnancies.

Medications:  -Antihypertensives in pregnancy -IV Magnesium Sulfate (drug of choice, the monitoring & the antidote)

Other medications(Hyperemesis Gravidarum):  -Ginger (non-pharmacological)-Diclectin™  -Gravol™  -Maxeran™  -Zofran™

1.     Differentiate between the terms “seizure” and “epilepsy”.

• Paroxysmal behavior caused by abnormal discharge

of neurons.

• Relation to acute illness

2.     Describe the etiology and pathophysiology of seizures.

• Genetic

• Structural/metabolic

• Neuronal discharges

• Unknown

• Phases of seizure

3.     Identify contributing factors to febrile and neonatal seizures.

• Illness

• Infection

• Asphyxia

• Electrolyte imbalances

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1.     Describe the pathophysiology, clinical manifestations and nursing care of gestational problems.

Pre-eclampsia/Eclampsia ♦ HELLP syndrome ♦ Gestational Diabetes ♦ Hyperemesis Gravidarum ♦ Hemorrhagic conditions

2. Describe the care of the pregnant woman with a pre-existing condition.

Obesity ♦ Diabetes ♦ Thyroid disorder ♦Cardiovascular/Pulmonary

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 4. Describe diagnostic tests used to assess maternal and fetal well-being.

Antepartum/Prenatal testing: • 1st trimester • 2nd trimester • 3rd trimester

5. Describe the care of the pregnant woman with a pre-existing condition.

RH/ABO Incompatibility - RhoGAM/WinRho

 Group B streptococcal (GBS) - Penicillin

6. Discuss the role of the nurse in a pregnancy at risk.

Antenatal risk assessment ♦ Educator ♦ Support

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 2. Discuss determinants of health as risk factors and their implications for pregnancy.

• Biology & Genetic Factors • Demographic Characteristics • Personal Health Practices & Coping Skills

3. Explore Canadian maternal health problems.

• Causes of maternal death • Mental health issue •Intimate partner violence

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9. Identify danger signs during pregnancy

Table 11-2 Signs of Potential Complications during the 1st, 2nd & 3rd Trimesters

• vaginal bleeding /vaginal discharge • rupture of membranes (ROM and PROM) • uterine contractions • swelling of fingers or face •continuous headache • visual disturbances • persistent or severe abdominal pain• chills/fever • painful urination • diarrhea • persistent vomiting • change infrequency or strength of fetal movement • glycosuria

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 7. Describe health teaching to promote adaptation during pregnancy

Teaching Health Behaviors: • recognizing potential complications • breast care • exercise, Kegel exercises • rest and sleep • employment • exposure to teratogens • travel• over-the-counter drugs, herbal preparations • tobacco, alcohol, caffeine • immunizations• transition to the parenting role – prenatal classes

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Identify factors that will influence the process of maternal role transition.

Psychosocial and Cultural Assessment:

·      psychological response to pregnancy

·      availability of resources

·      communication style

·       health beliefs

·       language

·      culture

6. Describe common discomforts of pregnancy, causes and measures that prevent or give relief.

Table 11-4Discomforts Related to Pregnancy

·       nausea and vomiting

·       heartburn

·       backache

·       urinary frequency

·       constipation

·       varicosities

·       hemorrhoids

·       leg cramps

·       ankle edema

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Describe the psychological responses to pregnancy.

- maternal responses during pregnancy:

• 1st trimester

• 2nd trimester

• 3rd trimester

- maternal adaptation

- accepting the pregnancy

- identifying with the mother role

- reordering personal relationships

- establishing a relationship with the fetus

- preparing for childbirth

- paternal adaptation

- sibling adaptation

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Common Lab Tests

·      Blood grouping

·      CBC, Hemoglobin (Hgb)

·      RH factor and antibody screen

·       Rubella

·      Hepatitis B screen

·      STD’s

·       Urinalysis

·       Maternal blood glucose

·       GBS (Group B Strep)

- Ongoing Assessment

·      vital signs

·      weight

·       urinalysis – protein, glucose, ketones

·       fundal height

·      Leopold’s maneuvers

·       fetal heart rate

·       fetal activity

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1.     Describe maternal physiological and psychosocial changes that occurduring pregnancy.

2.     Identify signs of pregnancy

a.     Presumptive

b.     Probable

c.     Positive

3. Describe antepartum assessment.

Initial Assessment

- History:

·       calculate (GPAL = gravida, para, abortions, living children) and length of gestation

·       any maternal or infant complications/multiple gestation

·       calculate Estimated Date of Birth (EDB)

8. Describe perinatal care choices.

• Physician care • Midwives • Doulas • Birth plan

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1.    Relate the pathology to therapy; describe pharmacological and nursing interventions associated with an acute respiratory illness in the pediatric population.

a.     Epinephrine, dexamethasone, bronchodilators, corticosteroids, nebulized normal or hypertonic saline, etc.

b. Oxygen therapy, cold humidity, corticosteroid therapy, inhalation therapy, positioning, maintaining a calm environment, Croup score, hydration, prevention and health teaching

4. Identify nursing interventions relative to the child with ASD and his/her family.

• Offering family support

• Identifying signs of anxiety or depression in family members

• Encourage family to seek assistance or servicesrelated to respite care or support groups
• Interdisciplinary approach and collaboration

• Involve family in care planning during hospitalization

• Individualize care

• Adapt physical environment as needed

• Communication approaches

• Medications that can be used to manage the behaviors associated with ASD

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1.    Describe the diagnostic tests used in respiratory illnesses.

a.      Arterial blood gases

b. Nasopharyngeal aspirations and cultures

c. Chest x-rays

d. Bronchoscopy

2.    Describe the signs and symptoms indicating a potential respiratory emergency.

a.     Respiratory assessment, chest auscultation, changes in mental status

b. Maintain a patent airway, manage infection, manage inflammation

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1.    Describe the differences in the anatomy and physiology of the pediatric respiratory system that increase the risk for respiratory illness.

2.    Assess signs and symptoms, analyze causative and contributing factors, formulate nursing diagnoses, set goals, determine nursing interventions and evaluate interventions in the different respiratory challenges for children and adolescents.

• Upper airway infections: Croup and epiglottitis

• Lower airway infections: Bronchitis and bronchiolitis

• Respiratory syncytial virus (RSV)

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1.    Describe the use of various medications in the management of intrapartum and postpartum complications.

a.     Tocolytics

b. Glucocorticoids

c. Anti-inflammatories

d. Electrolytes

e. Anticoagulants

f. Uterine stimulants

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1.    Describe the etiology, nursing care and therapeutic management of various postpartum complications.

a.     Rupture of uterus

b. Amniotic fluid embolism (anaphylactoid syndrome)

c. Inversion of uterus

d. Abnormal adherence of placenta (placenta accreta)

e. Trauma (injuries)

f. Postpartum hemorrhage

g. Venous thromboembolic disorders

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1.     Describe the etiology, nursing care and therapeutic management of various intrapartum complications.

a.      Spontaneous preterm labor

b. Premature rupture of membranes (PROM)

c. Chorioamnionitis •Dystocia

d. Precipitous labor

e. Prolapsed umbilical cord

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1.     Formulate guidelines for preparing children of different age groups for procedures.

a.      Before the procedure

b.      During the procedure

c.       After the procedure

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1.    Identify communication strategies for communicating with children of different age groups.

a.      Infant

b.    Toddler

c.     Pre-schooler

d.    School-age

e.     Adolescent

2.    Identify and discuss communication approaches to use when caring for a child with a cognitive impairment.

a.     Autism Spectrum Disorders- special considerations

b.    Cerebral palsy

c.      Brain injury

d.    Sensory impairment

e.     Sedation

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1. Describe challenges nurses face related to communicating with children and families.

a.     Establishing a setting for communication

b.    Communicating with parents

c.     Blocks to communication (nurse and patient)

2.    Identify developmental factors that influences communication

a.     Infancy

b.    Early childhood

c.      School-age years

d.     Adolescence

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1.     Identify treatment goals for ASD.

• Reducing disruptive behaviors

• Teaching the child how to accomplish purposeful activities

• Improving communication skills

• Providing opportunities for socialization

• Improving self-care skills

• Alleviating family distress

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1.     Describe the etiology of autism spectrum disorder (ASD).

• Developmental disorder

• Risk factors

• Diagnosis

2.     Identify signs and symptoms associated with ASD.

• Impaired social functioning

• Impaired language development

• Stereotypical behaviors

• Self-mutilation

• Increased aggression in adolescence

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