Title COMPRE - HANDOUTS - PEDIA (Mr. Alviz) ✅

TOP RANK REVIEW ACADEMY, INC. Page 1 | COMPREHENSIVE PHASE HANDOUTS PEDIATRIC NURSING Prepared By: Mr. Archie Alviz, RN,RM,MN,MAN,NCII NOVEMBER 2025 Philippine Nurse Licensure Examination Review Growth and development a. Cephalocaudal b. Proximo-distal c. Gross to Fine d. General to Specific Neurologic Disorders Increased ICP S/sx Young children 1. Bulging fontanels 2. High-pitched cry 3. Increased head circumference 4. Irritability and restlessness Older Children 1. Headache 2. Projectile vomiting 3. Declining school performance 4. Inability to follow simple commands 5. Diplopia and blurred vision 6. Anorexia, nausea, weight loss 7. Seizures Late manifestations 1. Decreased LOC (lethargy to coma) 2. Abnormal sensation to pain stimuli 3. Anisocoria 4. Decerebrate – midbrain dysfunction 5. Decorticate – cerebral cortex dysfunction 6. Papilledema 7. Cheyne-Stokes respiration Management for Increased ICP 1. Position: Semi Fowlers 2. Coughing and sneezing is avoided 3. Limit fluid intake 1,200 – 1,500 ml Pharmacotherapy - Mannitol – osmotic diuretic - Lasix – loop diuretic - Decadron (dexamethasone) - Anticonvulsants – valium, dilantin, carbemazepine - Antacids - Anticoagulants ** REMEMBER: Opiates and sedatives are contraindicated in increased ICP Seizure Disorder GRANDMAL SEIZURE - Tonic-clonic – dyspnea, saliva, and urine - Post-ictal phase – exhaustion PETITE MAL - Blank facial expression, automatisms, lip smacking JACKSONIAN SEIZURE - Tonic clonic of group of muscles that proceeds to grandmal PSYCHOMOTOR SEIZURE - Mental clouding intoxication FEBRILE SEIZURE - Under 5 STATUS EPILEPTICUS - Brain damage could occur Pharmacotherapy 1.Hydantoins e.g. phenytoin, mepenytoin, ethotoin - WOF gingival hyperplasia, pinkish red urine 2. Benzodiazepines e.g. diazepam, lorazepam 3. Iminostilbenes e.g. carbemazepine – for refractory seizures 4. Valproates e.g. valproic acid – hepatotoxic and can cause neural tube defects Bacterial Meningitis -Infection of the meninges S/sx: - Kernig’s sign - Brudzinski sign - Nuchal rigidity - seizures - Opistotonus Diagnostics CSF analysis a. Cloudy b. Elevated WBC c. Elevated protein Presence of causative agent Cardiovascular Disorders Patent Ductus Arteriosus MANIFESTATION: - machine-like murmur - Signs of Heart failure - Poor feeding - Fatigue - Poor weight gain - Irritability Septal defects S/sx Failure to thrive Fatigue s/sx of heart failure * NLE * NCLEX * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY * MED TECH