NCLEX Review: Pediatrics Module
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This week, we will be covering the Pediatrics Module from our Online NCLEX Review. The topics covered in this review are Pediatric Safety Considerations, Muscular Dystrophy Assessment, Pediatric Disorders, and a Sample NCLEX Question
Pediatric Safety Considerations
Challenges in the hospital
- Child may have separation anxiety. Playing peek-a-boo and hide and seek demonstrates to the child the parent is going to return.
- Stages of separation anxiety include protest, despair, and detachment. Crying and kicking is the protest phase.
General safety considerations
- No small toys under the age of 4 years.
- Always remember the importance of supervision in the toddler years. They are inquisitive and can reach things that could start a fire or hurt them.
- Accidents are the major cause of death for children and adolescents. Need to consider safety and accident prevention in the population.
- No metal or electric toys with oxygen.
- No toys or items which harbor germs. Stuffed toys are not good. Should be washed if at the hospital.
Pain in children
- Pain is remembered after 6 months of age.
- Wong-Baker Faces scale commonly used.
- After age 9, they can use numeric pain scale.
Muscular Dystrophy Assessment
Muscular dystrophy: Genetic disorder with progressive muscle weakness and wasting and increasing disability and deformity. Various types with specific muscle groups are affected.
- Impaired chewing
- Difficulty swallowing
- Abnormal gait
- Frequent falls
- Delayed intellect in some
- CPK elevated.
- EMG identifies origin of muscle weakness.
- Muscle biopsy to confirm
- Care focuses on preserving and promoting mobility
- Prevention of complications of immobility
- Interact at developmental age
- ROM important
- Aspiration precautions
- Genetic counseling
Care of the chronically ill child
- Focus on developmental age, not chronological.
- Determine how the child is cared for at home.
- Maintain routine if possible.
- Assess family response to child’s illness and involve them in care as much as possible.
- Assist child/family to return to normal pattern of living.
- Promote maximum growth and development.
In children with heart failure, implement measures to decrease the workload of the heart and increase cardiac output.
- Limit the time for bottle feed or breast feed.
- Elevate the head of the bed.
- Allow for uninterrupted rest periods.
- Provide oxygen during stressful periods.
- Digoxin (Lanoxin) frequently given.
- Give one hour before or 2 hours after a meal.
- Do not mix with formula, breast milk or other foods.
- Keep locked up for safety.
- Vomiting is an early sign of toxicity.
- Neurological signs of toxicity includes fatigue, muscle weakness and drowsiness.
Sample NCLEX Question
Take a quick look at this sample NCLEX Question and the detailed explanation below.
Respiratory syncytial virus (RSV): Most common cause of lower respiratory tract infections (pneumonia and bronchiolitis) in children worldwide. Virtually all children contract it by the age of three.
Contact precautions are implemented. Not airborn precautions. The virus can live on paper or skin for up to one hour and on other surfaces for six hours.
Treat with ribavirin (Virazole) in severe cases. Should wear goggles and a mask whenever given. Causes headaches, burning nasal passages and eyes, and crystallization of soft contact lenses. Can damage the fetus in a pregnant woman. Those pregnant should not be around the child.
Palivizumab (Synagis) may be given to high risk children to provide passive immunity. Includes those with a history of prematurity, lung disease, or congenital heart disease.
It may play a major role in the pathogenesis of asthma and chronic obstructive pulmonary disease.
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