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HESI®-RN Comprehensive Review
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Pain Assessment and Management in the Pediatric Client

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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid

Pain Assessment and Management in the Pediatric Client
31 Picmonics to Learn | 54 mins
Pain Assessment
Types of Pain
Acute Pain
Chronic Pain
OPQRST Mnemonic
Onset
Provoking or Palliative
Quality
Radiation
Severity
Timing
Nursing Considerations
Subjective Findings
Objective Findings
Reassessment of Pain
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2 mins
First Generation Antihistamines
Mechanism of Action
Histamine H1 Receptor Antagonist
Indications
Allergies
Nausea and Vomiting
Motion Sickness
Anaphylaxis
Drug Names
Diphenhydramine (Benadryl)
Promethazine (Phenergan)
Chlorpheniramine
Side Effects
Sedation
Anticholinergic Effects
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2 mins
Rubeola (Measles)
Mechanism
Virus
Signs and Symptoms
Fever
Red Maculopapular Rash
3 C's
Photophobia
Koplik Spots
Considerations
MMR Vaccination
Antipyretics
Vitamin A Supplementation
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2 mins
Mumps Virus
Characteristics
Paramyxovirus
Signs and Symptoms
Parotitis
Increased Serum Amylase
Orchitis
Oophoritis
Aseptic Meningitis
Pancreatitis
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59 secs
Paramyxovirus
Characteristics
Enveloped
RNA Virus
Helical
SS Negative Linear
Nonsegmented
Surface Fusion Protein Causes Multinucleated Cells
Presentation
Measles
Mumps
Bronchiolitis in Babies
Viruses
Parainfluenza
Respiratory Syncytial Virus (RSV)
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2 mins
Rubella
Mechanism
Rubella Virus
Signs and Symptoms
Swollen Glands
Cold-like Symptoms
Pinkish-red Maculopapular Rash
Low Grade Fever
Considerations
Rubella Titer
Avoid Contact with Pregnant Women
MMR Vaccination
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2 mins
Rubella TORCH
Signs and Symptoms
Nonspecific TORCH Symptoms
Patent Ductus Arteriosus
Pulmonary Artery Hypoplasia
Cataracts
Deafness
Blueberry Muffin Rash
Glaucoma
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1 min
Varicella (Chickenpox)
Mechanism
Varicella Zoster Virus (VZV)
Signs and Symptoms
Red Maculopapular Rash
Vesicles Ooze and Crust
Pruritus
Centripetal
Considerations
Varicella Immunization
Skin Care to Minimize Itching
Isolate until Vesicles Crust
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2 mins
Pediatric Vaccinations - Age 2 Months
2 B DR HIP
Hepatitis B
DTaP - Diphtheria Tetanus acellular Pertussis
RV - Rotavirus
HiB - Haemophilus Influenzae Type B
IPV - Inactivated Polio Vaccine
PCV - Pneumococcal
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1 min
Pediatric Vaccinations - Age 4 Months
4 DR HIP
DTaP - Diphtheria Tetanus acellular pertussis
RV - Rotavirus
HiB - Haemophilus Influenzae Type B
IPV - Inactivated Polio Vaccine
PCV - Pneumococcal
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1 min
Pediatric Vaccinations - Age 6 Months
B DR HIP In 6 Months
Hepatitis B
DTaP - Diphtheria Tetanus acellular pertussis
RV - Rotavirus
HiB - Haemophilus Influenzae Type B
IPV - Inactivated Polio Vaccine
PCV - Pneumococcal
Influenza
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2 mins
Pediatric Vaccinations - Age 12 to 15 Months
1 Very MAD HIP-ster
Varicella Zoster
MMR
Hepatitis A
DTaP - Diphtheria Tetanus acellular pertussis
HiB - Haemophilus Influenzae Type B
IPV - Inactivated Polio Vaccine
PCV - Pneumococcal
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2 mins
Pediatric Vaccinations Age 4-6 Years
Very DIM between 4-6pm
Varicella Zoster
DTaP - Diphtheria Tetanus acellular pertussis
IPV - Inactivated Polio Vaccine
MMR
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1 min
Haemophilus Influenzae Disease
Disease
Pneumonia
Cherry Red Epiglottitis
Meningitis
Otitis Media
COPD Exacerbation
Thumbprint Sign (on X-ray)
Treatment
Rifampin Prophylaxis
Ceftriaxone
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2 mins
Hepatitis B (HBV) Assessment
Transmission
Bodily Fluids
Blood Transmission
People Who Use IV Drugs
Incubation
Variable 1-6 Months
Assessment
Fever
Nausea and Vomiting
Hepatomegaly
Chronic Disease
Cirrhosis
Hepatocellular Carcinoma
Considerations
Vaccination
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2 mins
Tuberculosis Skin Mantoux Test (PPD)
Delayed Hypersensitivity (Cell Mediated Response)
Intradermal Injection
Read 48-72 hours
Positive Results
≥ 5 mm Induration
Immunosuppressed
≥ 10 mm Induration
High Risk Patients
≥ 15 mm Induration
Considerations
Chest X-Ray
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3 mins
Iron Deficiency Anemia
Causes
Malnutrition/Malabsorption
Hemorrhage
Signs
Microcytic, Hypochromic Anemia
Decreased Heme Synthesis
Labs
Decreased Reticulocytes
Decreased Ferritin
Increased Red Cell Distribution Width (RDW)
Poikilocytosis
Anisocytosis
Increased Central Pallor
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2 mins
Vitamin A (Retinol)
Mechanism
Maintains Mucous Membranes
Eyes and Skin
Indications
Dietary Deficiency
Skin Disorders
Side Effects
Hepatosplenomegaly
Jaundice
Increased ICP
Vomiting
Considerations
Teratogen
Animal Food Products
Dark Green and Orange Fruits/Vegetables
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2 mins
Vitamin C (Ascorbic Acid)
Mechanism
Antioxidant
Collagen Formation
Steroid Synthesis
Indications
Dietary Deficiency
Scurvy
Side Effects
GI Distress
Considerations
Citrus Fruits
May Improve Healing
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2 mins
Vitamin B6 (Pyridoxine)
Mechanism
Amino Acid and Protein Metabolism
Heme Synthesis
Neurotransmitters
Indications
Adjunct to Isoniazid
Dietary Deficiency
Premenstrual Syndrome (PMS)
Side Effects
Ataxia
Peripheral Neuropathy
Contraindications
Levodopa
Considerations
Cereals and Meats
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3 mins
IV Solutions
Hypotonic (< 280 mOsm/L)
1/4 Normal Saline (0.225% NaCl)
1/2 Normal Saline (0.45% NaCl)
Isotonic (280-300 mOsm)
Normal Saline (0.9% NaCl)
Lactated Ringer's (LR)
Dextrose 5% in Water (D5W)
Hypertonic (> 300 mOsm)
3% or 5% NaCl
Dextrose 5% in 0.45% NaCl
Dextrose 10% in Water (D10W)
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3 mins
Rule of 9's for Burns
Total Body Surface Area (TBSA)
Head
Anterior Torso (18%)
Chest
Abdomen
Posterior Torso (18%)
Upper Back
Lower Back
Extremities
Posterior Leg (each)
Anterior Leg (each)
Each Arm
Genitalia 1%
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2 mins
Types of Burns
Superficial Thickness
Sunburn
Superficial Partial Thickness
Blisters
Blanching
Deep Partial Thickness
Little or Non-blanching
Full Thickness
Waxy White, Yellow or Black
Decreased Pain
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2 mins
Parkland Formula
Burn victims
24 hours
TBSA% x Weight x 4 = Fluids
TBSA %
x Weight (kg)
x 4
= Fluid Requirement (in first 24 hrs)
Fluids in first 8 hours
1/2 of fluid given in first 8 hours
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1 min
Child and Elder Physical Abuse Assessment
Physical Abuse
Inconsistent Injuries
Delay in Treatment
Various Stages of Healing
Child Abuse
Symmetrical Burns
Sexually Transmitted Infection
Bloody/Torn Undergarments
Shaken Baby Syndrome
Elder Abuse
Poor Hygiene
Overmedication
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2 mins
Abusive Head Trauma (Shaken Baby Syndrome)
Presentation
Subdural Hemorrhage
Retinal Hemorrhages
Bruising and Fractures
Diagnosis
CT of Head
Skeletal Survey
Treatment
Document Injuries
Notify Child Protective Services
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1 min
Aspirin Poisoning (Salicylism) Assessment
Early Symptoms
Nausea and Vomiting
Tinnitus
Confusion
Hyperventilation
Respiratory Alkalosis
Late Symptoms
Metabolic Acidosis
Coma
Hyperthermia
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1 min
Activated Charcoal (Actidose)
Mechanism
Binds to Toxins
Indications
Ingested Poison
Side Effects
Black Stool
GI Distress
Considerations
Give As Soon As Possible
Via Mouth or NG Tube
Gastric Lavage
Do Not Administer with Antidotes
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2 mins
Naloxone (Narcan)
Mechanism
Competitive Opioid Receptor Antagonist
Indications
Opioid Induced CNS Depression
Side Effects
Severe Nausea and Vomiting
Excitable State
Opioid Withdrawal Symptoms
Considerations
Repeated Dosing Often Required
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1 min
Lead Antidotes
Antidotes
Dimercaprol
CaEDTA
Succimer
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39 secs
Arsenic, Gold and Copper Antidotes
Toxic Metals
Arsenic
Gold
Copper
Antidotes
Penicillamine
Dimercaprol (BAL)
Succimer
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2 mins

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