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Peds > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Erikson’s stages listed in order

A

-Trust vs. Mistrust
- Autonomy vs. shame and doubt
- Initiative vs. guilt
- Industry vs. inferiority
- Identity vs. confusion

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2
Q

Trust vs. Mistrust

A

Birth to 18 months

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3
Q

Autonomy vs. Shame and doubt

A

18 months to 3 years

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4
Q

Initiative vs. guilt

A

3-5 years

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5
Q

Industry vs. Inferiority

A

5-12 years

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6
Q

Identity vs confusion

A

12-18 years

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7
Q

List Piaget’s stages in order

A
  • Sensorimotor stage
  • Preopertational stage
  • Concrete Operational stage
  • Formal operational stage
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8
Q

Sensorimotor stage

A
  • birth to 24 months old
  • Motor activity w/o use of symbols
  • all things learned through experiences or trial and error
  • goal is object permanence
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9
Q

Pre-operational Stage

A
  • 2-7 years old
  • Development of language, memory, and imagination
  • Intelligence is both egocentric and intuitive
  • Goal is symbolic thought
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10
Q

Concrete Operation stage

A
  • 7-11 years old
  • More logical and methodical manipulation of symbols
  • less egocentric + more aware of outside world and events
  • goal is operational thought
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11
Q

Formal operational stage

A
  • Adolesence to adulthood
  • Use of symbols to relate to abstract concepts
  • able to make hypotheses and grasp abstract concepts and relationships
  • Goal is abstract concepts
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12
Q

Hep B Immunization dates

A
  • A birth
  • between 1-2 months
  • between 6-18 months
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13
Q

RV (rotavirus) immunization dates

A
  • 2 months
  • 4 months
  • 6 months
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14
Q

DTap immunization dates

A
  • 2 months
  • 4 months
  • 6 months
  • between 15-18 months
  • 4-6 years
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15
Q

Hib immunization dates

A
  • 2 months
  • 4 months
  • 6 months
  • between 12- 15 months
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16
Q

PCV13 (pneumococcal) immunization dates

A
  • 2 months
  • 4 months
  • 6 months
  • between 12- 15 months
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17
Q

IPV (inactivated polio vaccine)

A

Subcutaneous
- 2 months
- 4 months
- between 6-18 months
- 4-6 years

18
Q

Influenza immunization dates

A

Yearly starting at 6 months

19
Q

MMR immunization dates

A
  • between 12-15 months
  • 4-6 years
    (Same as varicella)
20
Q

Varicella immunization dates

A
  • between 12-15 months
  • 4-6 years
    (Same as MMR)
21
Q

Hep A immunization dates

A
  • between 12-23 months
    Second dose 6 months later
22
Q

Asthma
(Patho, Dignostic tests, Sx, nursing care, medication, and family education)

A

Patho:
chronic inflammatory disorder in which airways narrow and become hyperactive to stimuli that don’t affect individuals without asthma

Diagnostic tests:
Chest x-ray and pulmonary function tests

Symptoms:
- wheezing
- dry cough
- prolonged expiration
- restlessness
- fatigue
- tachypnea
- cyanosis

Medication:
- bronchodilators
- steroids

Family Education:
-Teach to identify and avoid triggers
- Check peak flow daily
- keep rescue inhaler w/ patient at all times

23
Q

RSV

A
  • Most frequent cause of hospitalization in children <1 yo
  • severe RSV infections in first year of life are a significant risk factor for the development of asthma

Patho:
- RSV is transmitted from exposure to contaminated secretions (can live on fomites for several hours and on hands for 30 minutes)
- usually begins with a URI after incubation of about 5-8 days

Symtoms:
- Rhinorrhea and low grade fever appear first
- OM and conjunctivitis may also be present
- contagious for 3-8 days some patients with weakened immune systems can be contagious for as long as 4 weeks

Diagnostic test:
- Hyperinflation of the lungs is seen usually on chest x-ray
- DFA
- ELISA for RSV antigen detection

24
Q

Cystic fibrosis

A

Patho:
- multisystem disorder of exocrine glands
- increased production of thick mucus in bronchioles, small intestines, and pancreatic and bile ducts
- lungs — actelectasis
- clogged pancreatic ducts
- absence of pancreatic enzymes in small intestines (unable to absorb fats + protein)

Etiology:
- inherited of autosomal recessive trait (usually diagnosed in infancy/early childhood)
- life expectancy increasing ~30 years now

Diagnosis:
- sweat test
- 72 hours fecal fat
- Chest x-ray
- prenatal DNA of amniotic

Treatment:
- antibiotics — treat pulmonary infection
- pancreatic enzymes — for fat absorption
- fat soluble vitamins A, E, D, K
- MUCOLYTICS to decrease viscosity of sputum
- bronchodilators

Signs and symptoms:
- cough, sputum, dyspnea, decreased SpO2, crackles or wheezes in lungs, cyanosis, digital clubbing, bulky frothy foul-smelling stools (steatorrhea), meconium ileus

Nursing care:
- assess hydration status
- provide high calorie high protein foods
- administer pancreatic enzymes with all meals and snacks
- avoid pulmonary treatments after meals to decrease the chance of vomiting
- chest percussion and postural drainage
-activity and exercise will loosen secretions

25
Q

Epiglottitis

A

Patho:
- inflammation and swelling of epiglottis (primarily affecting children b/t ages 2-8)
- Bacteria (usually haemophilus influenzae) cause epiglottis to become cherry red and so swollen that it obstructs airway

Symptoms:
- child has sore throat + unable to swallow
- secretions pool in pharynx and larynx
- Onset is sudden with high fever, sore throat, and pain w/ swallowing
-dysphonia, dsyphagia, drooling of saliva
- anxious, restless, insists on sitting upright with chin thrust out, mouth open, and in tripod position

Diagnosis:
- EXAMINATION OF THE THROAT IS CONTRAINDICATED (physical manipulation of hypersensitive airway muscles may result in spasm + complete obstruction)
- lateral neck x-ray confirms enlarged epiglottis
- CBC, blood cultures

Nursing care:
-NPO, IV fluids for hydration
-assess for resp. Distress continuously
- dont leave child unattended!
-keep intubation equipment available

Medications:
-antibiotics
-antipyretics
-corticosteroids

Education:
-discuss importance of Hib vaccine and ensure parents that the reoccurrence of epiglottitis is uncommon

26
Q

Hemolytic Uremic Anemia

A

Triad of HUS: Anemia, thrombocytopenia, renal failure

Patho:
- primary site endothelial lining of the small glomerular arterioles-swell and occluded w/ deposits of platelets and fibrin clots
- RBC are damaged moving through partially occluded blood vessels
- Damaged RBC are removed by spleen causing acute hemolytic anemia and thrombocytopenia

Clinical manifestations:
- primarily in 6mo-5yo
- begins with gastro infection or URI
- associated with e. Coli (acquired in undercooked beef, unpasteurized milk or fruit juice, greens or drinking/swimming in sewage contaminated water)

Treatment:
- hemodialysis or peritoneal dialysis
-FFP and plasmaphereis, fresh/washed packed cells

27
Q

Hirschsprung

A

Patho:
- congenital absence of ganglion cells
- Nerve cells are missing in the large intestines so stool can’t be moved + becomes blocked
- Colon becomes a “mega colon”

Clinical manifestations:
- No meconium within 1st 24-48 hours
- Distended abdomen & vomiting
- Signs of enterocolitis
- Chronic constipation
- RIBBON-LIKE, FOUL-SMELLING STOOL

Post op:
- NPO + NG suction
- Ostomy-temporary

28
Q

Pyloric Stenosis

A

Patho:
- Hypertrophy of circular muscle of pylorus which causes the constriction of pylorus and obstruction of gastric outlet

Clinical manifestations:
- Projectile vomiting
- moveable olive-shaped mass in epigastrium

Treatment:
-pyloromyotomy
-laparotomy (relatively uncomplicated surgery)
- Feeding 4-6 hours postop, progressing from glucose or electrolyte fluid to formula within 24 hours of surgery
- Discharge home 2nd postop day

29
Q

Vomiting

A
  • Common in children; self-limiting
  • Requires no specific treatment unless complications occur (dehydration, electrolyte imbalances, aspiration)

Associated with
- infectious disease
- increased ICP
- Toxic ingestion
- food intolerance and allergy
- mechanical obstruction of GI tract
- Metabolic disorder

30
Q

Rotavirus

A

-most common in children 3mo-24mo
-fecal - oral transmitted
- fever
- starts with vomiting then watery, grassy green foul smelling diarrhea
- oral preventative given with immunizations at 2 months, 4 months, and 6 months

31
Q

Salmonella

A
  • bacterial
  • person to person or under cooked chicken
  • June-August
  • Hamsters, turtles, dogs, and cats carry it too
  • Nausea, vomiting, abdominal pain, BLOODY DIARRHEA
    -fever
    -may become septic
32
Q

Shigella

A

-fever, fatigue, anorexia
-cramps abdominal pain preceding watery or bloody diarrhea
-do not give antidiarrheal medications!!!

33
Q

GERD

A

GER: transfer of gastric contents into the esophagus
GERD: tissue damage from GER

Symptoms:
-poor weight gain
-esophagitis
-persistent respiratory symptoms or complications
-spitting up/vomiting
-difficulty swallowing
-chest pain + heart burn

Treatment:
- avoid trigger foods (citrus, caffeine, etc.)
- weight control
- small frequent meals
- thickened feeds
- elevate HOB for 1 hour after feed
-PPI’s-omeprazole, H2 receptor inhibitors-ranitidine

34
Q

Hepatitis B vaccination contraindication

A

Bakers yeast allergy

35
Q

Rotavirus

A
  • most common cause of severe diarrhea
  • incubation period is approx. 2 days
    Signs + Symptoms:
  • vomiting and watery diarrhea for 3-8 days and fever and abdominal pain occur frequently
36
Q

Diphtheria

A
  • contact transmission
  • thick, bluish white to gray patches cover the tonsils
  • fever, anorexia, malaise, cough, hoarseness, odor, sore throat

Complications:
-myocarditis, ascending paralysis

Treatments:
-IV antitoxin, Pencillin

37
Q

Tetanus

A
  • Exists as spore in dirt, dust, animal excrema
  • endotoxin attacks the nervous system

Symptoms:
- stiff neck and jaw, facial spasms, difficulty swallowing, and MUSCLE RIGIDITY
- opisthotonus (back arch)
- lock jaw and muscle spasm (sardonic spasm)

Treatment:
- tetanus immunoglobulin, tetanus toxoid, ICU care, paralysis, ventilator

38
Q

Pertussis

A
  • Transmitted through droplets (direct contact)
  • runny nose, cough that becomes more severe and spasms, flushing, cyanosis, vomiting

Treatment:
- antibiotics
- steroids

39
Q

HPV

A
  • most common STI

Vaccine:
3 IM shots at
- 11-12 years old, 2 months later, and 6 months later

40
Q

Poliomyelitis

A

3 types of polio

Symptoms:
- fever, headache, stiff neck, progressive weakness, respiratory difficulties, paralysis

Complications:
- respiratory arrest
- Permanent motor paralysis

41
Q

Fifth’s Disease

A

caused by human parvovirus 19

Droplet precautions

Comes in 3 stages and first stage is redness to cheeks

Symptoms:
- “Slapped cheek”
- lacy rash on trunk and limbs
- some fetal defects

Peds (3 decks)

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