Cause  Lice

o Female egg
Factors Day care
Signs and  Common site: occipital,
Symptoms
Nursing  Have family checked
Management:  Health teaching: use of fine-tooth comb, do not share items
 Bedding and clothing should be laundered in hot water
 Keep non-essential clothes and toys for 2 weeks (storage room)
 Daily vacuuming
Medical Pediculicide
management  6 months below (contraindicated because it is chemically strong)

SCABIES
Definition Parasitic skin disorder
Cause  Sarcopetes scabiei
o Incubation: 4-5 weeks
o Eggs hatch: 3-5 days
o MOT: contact
Factors Day care
Signs and  Pruritic popular rash
Symptoms  Burrow into the skin
Diagnostics  Inspection
Nursing
Management:
Medical  Lindane Shampoo
management o Contraindicated: 2 years and below
o Adverse effect: seizure and neurotoxicity
 Permethrin
o Applied to cool, dry skin
o All skin areas

LEAD POISONING
Definition Excess lead in the blood
Cause  Exposed to dust, soil
 Adults: plumber, smoker, mechanic
 Near cars, highways
 Pencil, paint, crayon
Factors Toddlers with pica
Signs and  CNS: Permanent cognitive impairment
Symptoms  Renal: oliguria, hematuria
  Hematology: fatigue, forgetfulness, fainting, pallor
Diagnostics Blood test
- N: 5 mcg/dL
- Toxicity: 15 mcg/dL
Nursing Before therapy:
Management: - Check for kidney function (BUN and Crea)
- Adequate hydration
Provide health teachings
- Supervision in playgrounds
- Safe toys
- Monitor children with pica
Medical Chelation Therapy
management - Calcium disodium edetate
- Succimer
- British Anti-Lewisite
o Route: IM or IV
o Contraindicated: peanut allergy, G6PD
Ethylenediamine Tetra acetic Acid (EDTA) – binds to lead and excretes it via
kidneys

Acetaminophen Overdose
Cause Toxic dose of 150 mg/kg or higher in children
Factors Amount ingested
Length of time before treatment
Intentional
Liver failure
Signs and First 2-4 hours
Symptoms - Malaise
- Nausea/vomiting
- Sweating, pallor, weakness
Hepatic
- RUQ pain
- Jaundice
- Confusion, stupor (accumulation of non-metabolized wastes in the
body, affecting the brain - hepatic encephalopathy)
- Elevated liver enzymes
- Prolonged prothrombin time (decreased vitamin K)
Diagnostics Blood test

Rumack-Matthew Nomogram: test for acetaminophen relative to time of

ingestion
- Ask for the time or what time the patient was seen on the floor
Medical - Less than 4 hours: paracetamol at 4 hours post-ingestion
 Management: - 4-8 hours post-ingestion: immediate paracetamol concentration
- 8 hours post-ingestion: N-Acetylcysteine (add juice or soda)
- Unconscious: gastric lavage + activated charcoal
Drugs with toxicity and check the antidote

Acetylsalicylic Acid (aspirin)

Cause Acute ingestion: 300-500 mg/kg
Chronic ingestion: 100 mg/kg per day for 2 days or more
Signs and - Gastrointestinal effects: nausea, vomiting, dehydration
Symptoms - Central nervous system: confusion, tinnitus, seizure, coma
- Renal system: oliguria
- Hematology: Bleeding
- Metabolic effect: diaphoresis, fever, hyponatremia, hypokalemia,
metabolic acidosis
Medical Activated charcoal: decreases salicylate absorption
management IV fluids
Sodium bicarbonate
Vitamin K
Anticonvulsants

Corrosives
Cause Household cleaner, detergent, bleach, paint, batteries
Signs and Burned mouth, throat, and stomach
Symptoms Edema in tongue, lips, pharynx (WOF airway patency)
Vomiting
Drooling and inability to clear secretions
Medical Dilute corrosives with water or milk
management Contraindicated:
- Induced vomiting
- Neutralization (no activated charcoal) – can cause further burns

BOARD QUESTIONS
1. Nurse Webbie is aware that the best initial approach when trying to take a crying
toddler’s temperature is:
a. Talk to the mother first and then to toddler
b. Bring extra help so it can be done quickly
c. Encourage the mother to hold the child
d. Ignore the crying and screaming
2. Baby Webbie, a 3-month old infant, just had a cleft lip and palate repair. What should
the nurse do to prevent trauma to the operative site?
a. Avoid touching the suture line, even when cleaning
b. Place the baby in prone position
c. Give a pacifier
d. Place the infant’s arms in soft elbow restraints
3. Which action should nurse Webbie include in the care plan for a 2 month old with heart
failure?
a. Feed the infant when he cries
b. Allow the infant to rest before feeding
c. Bathe the infant and administer medications before feeding
d. Weigh and bathe the infant before feeding
4. Mommy Linda is playing with her infant who is sitting securely alone on the floor clinic.
The mother hides a toy behind her back and the infant looks for it. The nurse is aware
that the estimated age of the infant would be:
a. 6 months
b. 4 months
c. 8 months
d. 10 months
5. The reason why Nurse Webbie keeps the neonate in a neutral thermal environment is
that when a newborn becomes too cool, the neonate requires:
a. Less oxygen, and the BMR increases
b. More oxygen, and the newborn’s BMR decreases
c. More oxygen, and the newborn’s BMR increases
d. Less oxygen, and the newborn’s BMR decreases
6. Marjorie has given birth to a 42 weeks gestation baby. When assessing the neonate,
which physical finding is expected?
a. Sleepy baby
b. Lanugo
c. Desquamation of the epidermis
d. Vernix caseosa
7. Nurse Webbie is taking care of a 3-year old child who had a grand-mal seizure episode.
As she continues her assessment, which of the following observations could cause a
child to have a seizure?
a. Presence of crackling sounds
b. Presence of cardiac dysrhythmias
c. Presence of persistent elevated temperature
d. Presence of abdominal tenderness
8. A 4 year old was rushed to the emergency room after ingesting a harmful substance.
Nurse Webbie knows that activated charcoal can be used for certain substances. Which
of the following is contraindicated for activated charcoal as treatment?
a. The patient has history of diarrhea or vomiting
b. The substance was corrosive in nature
c. The toxic substance was ingested an hour ago
d. The patient had a history of abdominal surgery
9. Nurse Webbie is attending a birth and delivery where the mother has reported that the
amniotic fluid was thick and green when her water broke. Considering this scenario,
what would be the most crucial initial treatment for the newborn after delivery?
a. Providing oxygen through a nasal cannula at a rate of 4L/min
b. Suction the mouth and nose
10. Nurse Webbie is tending to a 2-year old girl, Hannah, who is showing signs of respiratory
distress. She’s been feverish with a runny nose for the last three days. Sophie is alert and
seated on her mother’s lap, her skin warm and flushed. She’s using her abdominal
muscles to breathe and her breathing effort seems increased. Her blood pressure is
88/66 mmHg, pulse 128 beats/min, and respirations 48 breaths per minute. What
assessment should Nurse Webbie immediately intervene as priority?
a. A presence of delayed capillary refill time
b. Inability to tolerate feeding
c. Existence of weak pulses
d. Presence of stridor
11. In the newborn nursery care, Nurse Webbie is preparing to administer needed vaccines
and injection. Which of the following is not routine protocol for nursery care?
a. BCG
b. Hepatitis B
c. 0.5 erythromycin
d. Vitamin K
12. Which of the following is most likely associated with Cerebrovascular Accident, resulting
from congenital heart disease?
a. Polycythemia Vera
b. Cardiomyopathy
c. Endocarditis
d. Low blood pressure
13. 6 years old…As the nurse, you see her in the clinic…
a. Autonomy vs Shame and Doubt
b. Industry vs Inferiority
14. A child is being taught toilet training. Which of the following are cues?
a. Can stay dry for 3 hours
b. Can sit and walk
c. Can communicate toilet needs
d. Can flush the toilet
15. When reviewing the management for sickle cell anemia with a parent. The nurse
understands further teaching is needed when the parent verbalizes this factor as part of
the sickle cell crisis?
a. Excessive vomiting
b. Fever
c. Foods that are low in iron
d. Emotional stress
Three management: dehydration, low O2, pain. Factors for sickle cell crisis: dehydration,
fever, stress, infection
16. A chronically ill school age child (7-12) is most vulnerable to what stressor?
a. Mutilation anxiety
b. Separation anxiety
c. Anxiety over school absences
d. Fear of hospitalization
17. Psychosocial analysis for her adolescent patient?
a. Becoming industrious
b. Establishing an identity
c. Achieving intimacy
d. Develop initiative
18. As the nurse, you are noting that an infant develops an arm movement before fine
motor movement, and interprets this as which pattern of development?
a. Cephalocaudal
b. Proximo-distal
c. Differentiation
d. Mass to specific
19. 2 years old. What time of play should you expect as a nurse?
Answer: parallel play
20.