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peds/obs > exam 1- PEDS > Flashcards

exam 1- PEDS Flashcards

1
Q

Jean Piaget (theorist)

A

swiss theorist on how children learn

framework for understanding how thinking during childhood progresses and differs from adult thinking

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2
Q

Piaget Infancy
Sensorimotor Period
Birth to 2yo

A

reflexive behavior used to adapt to environment

egocentric view of the world

development of object permanence [awareness object exists even when they disappear from sight]

at the end, infant shows more evidence of reasoning

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3
Q

Piaget Toddlerhood and Preschool Age
Preoperational Thoughts
2 to 7 yo

A

thinking remains egocentric

becomes magical [events due to wishing]

dominated by perception

language becomes useful

animism [all objects have life and meaning]

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4
Q

Piaget School Age
Concrete Operations
7 to 11yo

A

thinking becomes more systematic and logical

concrete objects and activities needed

concept of time becomes clear

far past and far future remain obscure

child cannot deal with abstractions or with socialized thinking

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5
Q

Piaget Adolescence and Adulthood
Formal operations
11yo to adulthood

A

concrete to abstract and symbolic

self-centered to other-centered

can develop hypothesis

improved organizational ability, task completion, behavioral attention, self control

understand logical consequences of behavior

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6
Q

significance of piaget’s theory

A

for nurses when developing teaching plans of care for children

believed that learning should be geared to the child’s level of understanding and should be an active participant in the learning process

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7
Q

Sigmund Freud (theorist)

A

theories to explain psychosexual development

early childhood experiences provide unconscious motivation for actions later in life

certain body parts assume psychological significance as foci of sexual energy

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8
Q

Freufd Infancy
oral stage

A

mouth is a sensory organ

1st half: infant takes in and explores during oral passive substage

2nd half: infant strikes out with teeth during oral aggressive substage

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9
Q

Freud Toddlerhood
Anal Stage

A

major focus of sexual interest is anus

control of body functions is major feature

toilet training a major developmental task

a time of holding on and letting go

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10
Q

Freud Preschool
Phallic or Oedipal/Electra Stage

A

genitals become focus of sexual curiosity

superego (conscience) develops

feelings of guilt emerge

possessiveness of child for opposite-sex parent, marked by aggressiveness toward the same sex parent

identifies with or become more like same-sex parent

superego develops [inner voice that reprimands and evoke guilt]

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11
Q

Freud School Age
Latency Stage

A

sexual feelings firmly repressed by the superego (less prominent in daily life)

period of relative calm

same-sex peer groups

younger: refuse to play with children of the opposite sex

older: desire companionship of opposite-sex friends

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12
Q

freud adolescence to adulthood
Puberty or Genital Stage

A

stimulated by increasing hormone levels

sexual energy wells up in force resulting in personal and family turmoil

interest in sex flourishes as search for identity

develop more adult view of sexuality

decisions often made based on emotional state

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13
Q

erik erikson (theorist)

A

viewed development as a lifelong series of conflicts affected by social and cultural factors

each conflict must be resolved for child and adult to progress emotionally

unsuccessful resolution leaves individual emotionally disabled

inspired by Freud

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14
Q

Erikson Infancy
Trust v Mistrust

A

infant’s physical and emotional needs met in timely manner = trustworthy

signs of unmet needs: restlessness, fretfulness, whining, crying, clinging, physical tenseness, vomiting, diarrhea, sleep disturbances

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15
Q

Erikson Toddlerhood
Autonomy v Shame and Doubt

A

development of sense of control over the self and body functions

exerts self

characterized by will

elimination accomplished

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16
Q

Erikson Preschool Age
Initiative v Guilt

A

development of a can-do attitude about the self

behavior becomes goal-directed

competitive and imaginative

initiation into gender role

characterized by purpose

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17
Q

Erikson School Age
Industry v Inferiority

A

mastering of useful skills and tools of the culture

learning how to play and work with peers

characterized by competence

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18
Q

Erikson Adolescence
Identity v Role Confusion

A

begins to develop a sense of “I”

peers become of paramount importance

child gains independence from parents

characterized by faith in self

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19
Q

Erikson Adulthood
Intimacy v Isolation

A

Development of ability to lose the self in genuine mutuality with another

characterized by love

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20
Q

Erikson Adulthood
Generativity v Stagnation

A

production of ideas and materials through work

creation of children

characterized by care

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21
Q

Erikson Adulthood
Ego Integrity v Despair

A

realization that there is order and purpose to life

characterized by wisdom

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22
Q

Significance of Erikson’s Theory

A

regression is a reactivation of behavior more appropriate to an earlier stage of development

provides a theoretic basis for much of the emotional care that is given to children

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23
Q

Lawrence Kohlberg (theorist)

A

moral development as a complicated process involving the acceptance of values and rules of society in a way that shapes behavior

closely parallels Piaget’s

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24
Q

Kohlberg Infancy
Premorality or Preconventional Morality
Stage 0 (0-2 yo)
Naivete and Egocentrism

A

no moral sensitivity

decisions made on basis of what pleases child

infants like or love what helps them (vice versa)

no awareness of the effect of their actions on others

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25
Q

Kohlberg Toddlerhood
Premorality or Preconventional Morality
Stage 1 (2-3 yo)
Punishment-Obedience Orientation

A

right or wrong determined by physical consequences

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26
Q

Kohlberg Preschool
Premorality or Proconventional Morality
Stage 2 (4-7 yo)
Instrumental Hedonism and Conerete Reciprocity

A

confirms to riles out of self-interest

behavior is guided by an “eye for an eye” orientation

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27
Q

Kohlberg School Age
Morality of Conventional Role Conformity
Stage 3 (7-10 yo)
Good boy or good girl orientation

A

morality based on avoiding disapproval or disturbing the conscience

child is more socially sensitive

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28
Q

Kohlberg School Age
Morality of Conventional Role Conformity
Stage 4 (10-12 yo)
Law and Order Orientation

A

right takes on a religious or metaphysical quality

child wants to show respect for authority and maintain social order

obeys rules for their own sake

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29
Q

Kohlberg Adolescence
Morality of Self-Accepted Moral Principles
Stage
Social Contract Orientation

A

right is determined by what is best for majority

exceptions to rules can be made if a person’s welfare is violated

the end no longer justifies the means

laws are for mutual good and mutual cooperation

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30
Q

Kohlberg Adulthood
Morality of Self-Accepted Moral Principles
Stage 6
Personal Principle Orientation

A

achieved only by morally mature individual

few people reach this level

do what they think is right regardless

actions guided by internal standards

integrity most important

may be willing to die for their beliefs

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31
Q

Kohlberg Adulthood
Morality of Self-Accepted Moral Principles
Stage 7
Universal Principle Orientation

A

achieved by rare few (Mother Teresa, Gandhi, Socrates)

transcend teaching of organized religion

perceive oneself as a part of cosmic order

understand reason for existence

live for their beliefs

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32
Q

Hepatitis A Vaccine

A

beginning at 12-23 months

2 doses should be given 6 months apart

if by 2yo and not vaccinated, can do so in subsequent visits

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33
Q

Hepatitis B Vaccine

A

1st dose: at birth
2nd dose: 1-2 months
3rd dose: 6-18 months

Four doses may be given if vaccine given in combination with other vaccines given to infants

readmission is OKAY!

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34
Q

Haemophilus Influenzae type B (HiB)

A

can cause meningitis in infants and young children

(cdc not book ) :
1st dose at 2 months > 2nd dose at 4 months > 3rd dose at 6 months

Booster dose: 12-15 months

readmission is OKAY!

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35
Q

Pneumococcal Conjugate Vaccine (PCV)

A

PCV-13

1st dose: 2 months
2nd dose: 4 months
3rd dose: 6 months
4th dose: 12 to 15 months

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36
Q

Meningococcal Conjugate Vaccine
(serogroup A, C, W, Y)

A

1st dose: 11 - 12 yo

Booster dose: 16 yo

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37
Q

Meningococcal Serogroup B Vaccine

A

Between 16-18 yo

given in 2 doses

shared decision

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38
Q

Rotavirus Vaccine

A

leading cause of GI disease in infants and young children

1st: 2 months
2nd: 4 months
3rd dose: 6 months (if 3 dose series)

DO NOT GIVE to children OLDER THAN 8 MONTHS

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39
Q

Human Papilloma Virus Vaccine (HPV)

A

decrease risk for lateral genital and oropharyngeal cancers

GOAL: administer before sexually active

1st dose: 11-12 yo
2nd dose: 9-14 yo
3rd dose: > 15 yo

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40
Q

Tetanus-Diptheria Acellular Pertussis (TDaP) Vaccine

A

used to prevent pertussis (whooping cough)

If DTap > 7 yo, low grade fever and mild diarrhea common

1st dose: 11-12 yo

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41
Q

Influenza Vaccine

A

beginning at: 6 months

if not given previously at younger than 9 yo > need to receive 2 doses initially with each 1 month apart

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42
Q

Measles, Mumps, Rubella (MMR)

A

1st: 12 months

2nd: 4-6 yo

LIVE! Do not give to pregnancy

Readmission is okay!

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43
Q

Varicella (VAR)

A

1st: 12 months

2nd: 4-6 yo

LIVE! Do not give to pregnancy

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44
Q

DTaP for < 7 yo

A

1st dose: 2 months
2nd dose: 4 months
3rd dose: 6 months
4th dose: 15-18 months
5th dose: 4-6 yo

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45
Q

Subcutaneous Injection- Peds Consideration

A

sites:
infant to 11 months: thighs
12 months and up: upper outer triceps

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46
Q

Intramuscular injection- Peds Consideration

A

newborn: 0-1 month
vastus lateralis

infants: 1-12 months
vastus lateralis

toddlers: 1-2 yo (18 mos < , deltoid preferred!)
vastus lateralis * preferred
if deltoid, use less inches

children: 3-10 yo and 11-18 yo
deltoid preferred
if vastus lateralis, use more inches

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47
Q

Immunization Considerations

A

fever and rash occur 1-2 weeks after administration of a live vaccine

age-appropriate acetaminophen q6h for 24 hrs is okay for any discomfort

cold compress for first 24h to painful or red injection sites followed by hot or cold compress as needed

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48
Q

Peds PE: Lymph Nodes

A

NORMAL: small, non-tender and moveable lymph nodes

Under the size 1-1.5cm without any other concerning

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49
Q

Peds PE: Head and Neck

A

4 months: normal head lag

> 6 months: significant head lag concerning for cerebral injury

Anterior Fontanelle: closes at 12-24 months of age (average 18 months)

Posterior Fontanelle: closed by 3 months in term infants

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50
Q

PEDS PE: Eyes and Ears

A

Red Reflex: absence may indicate cataract or reitnoblastoma (appears white instead of red)

Fixate on one visual field with both eyes: 3-4 months

Amblyopia blindness from disuse: by 3-6 yo

Visual Acuity test begins at around age 3

Ages < 3yo : straighten the ear canal by pulling the pinna down and back

Low-set is when the auricle does not cross or touch the line from the eye to the occiput

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51
Q

PEDS PE: Nose and Mouth

A

Allergic salute: transverse line on nose indicating allergies

Petechiae (white dots) on the mouth are abnormal

Tonsils often larger in younger children > large enough to cause partial airway during sleep (snoring)

Eruption usually starts around 6 months > most deciduous teeth present by 30 months

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52
Q

PEDS PE: Thorax and Lungs

A

Listen to breath sounds with child sitting upright

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53
Q

PEDS PE: Heart

A

PMI in 4th IC space in midclavicular line in children < 7 yo

PMI moves to 5th IC space in older children

Auscultate: lying down, sitting up and left lateral recumbent

Split S2 in children of all ages that widens during inspiration is
NORMAL and heard in pulmonic area

Breast development (thelarche) typically around 9-10 yo

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54
Q

PEDS PE: Abdomen

A

Umbilical hernia common in younger children and will close on its own for the first few years of life

Deep palpation may not be indicated or be contraindicated and reserved for advanced providers

May palpate an enlarged liver or spleen

Important to palpate femoral pulses in baby/young child

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55
Q

PEDS PE: Musculoskeletal

A

Focus on spine and extremities

Genu varum/bow leg: seen in toddlers but abnormal if unilateral or asymmetric

Genu valgum/knock knee: normal in children up to 7 yo

Gait is broad based in toddlers > lowers the center of gravity as they age and school aged (gradually resolved)

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56
Q

Neurologic System: 2 weeks to 2 months

A

Raise head and hold positions

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57
Q

Neurologic system: 2 months

A

Moves all extremities; kicks when prone

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58
Q

Neurologic system: 3 to 6 months

A

Draws up knees and raises abdomen off table; rocks and rolls over

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59
Q

Neurologic system: 7 months

A

Sit alone and uses hands for support (tripod)

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60
Q

Neurologic system: 9 months

A

Lurches forward and pulls legs to chest in “inchworm” fashion, may move backward in same fashion; creeps and rolls

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61
Q

Neurologic system: 6 to 9 months

A

Crawls in one-sided manner (moves arm and leg on the same side of the body then the other side )

Crawls in regular fashion, alternating arm and opposite leg:

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62
Q

Neurologic system: 11 months

A

begins to pull up

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63
Q

Neurologic system: 12 months

A

cruises [attempts to walk with support or holding onto something stable]

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64
Q

Neurologic system: once comfortable standing and holding on

A

Momentarily lets go and maintains balance fora few seconds

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65
Q

Neurologic system: once standing balance accomplished

A

takes first steps (broad stance, arms flexed)

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66
Q

Neurologic system: 12 months

A

sits from a standing posture

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67
Q

Neurologic system: 15 months

A

walk alone

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68
Q

Neurologic soft signs

A

AKA BAD

poor motor coordination, sensory perceptual difficulties, and involuntary movements…

Hard signs refer to impairments in basic motor, sensory, and reflex behaviors. In contrast, “soft” neurological signs (SNS) are described as nonlocalizing neurological abnormalities that cannot be related to impairment of a specific brain region or are not believed to be part of a well-defined neurological syndrome

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69
Q

PEDS PE- Neurologic
Clonus Reflex

A

continued, rapid flexion and extension of the foot and hand; elicited by suddenly and briskly dorsiflexing the foot or hand and applying sustained and moderate pressure

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70
Q

PEDS PE- Neurologic Abdominal Reflex

A

response ipsilateral contraction of abdominal muscle with movement of the umbilicus toward the side being stroked

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71
Q

PEDS PE- Neurologic Cremasteric Reflex

A

ipsilateral testicle elevates

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72
Q

PEDS PE- Neurologic Babinski Reflex

A

response in infant is dorsiflexion, fanning of toes and hyperextension of the great toe; once walking, the response should be plantar flexion of the toes

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73
Q

Newborn

A

birth to 1 month

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74
Q

infant

A

1 month to 1 year

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75
Q

toddlerhood

A

1 year to 3 years

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76
Q

preschool age

A

3 years to 6 years

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77
Q

school age

A

6 to 11 years, or 12+

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78
Q

Average infant weight

doubles
triples
quadruples

A

7.5 lbs

by 6 months
by 12 months
by 2-3 yrs

79
Q

head circumference measured

A

for brain growth

0-3 years

80
Q

primary dentation:

A

6 to 8 months

81
Q

most children have 20 teeth:

A

by 2.5 years

82
Q

full set of teeth

A

6 years

83
Q

vowels by

A

by 2 months old

84
Q

consonants by

A

5 months

85
Q

vocabulary of 300 words by

A

2 years

86
Q

sense of grammar by

A

4 years

87
Q

Gastric Acidity

A

gastric secretions of infants LESS ACIDIC

\milk/formula = alkalinity > decreases absorption of medications that require a more acidic environment

88
Q

Gastric emptying

A

unpredictable in infants ; slower than in older children > prolong medication absorption

89
Q

Gastrointestinal motility

A

infants up to 8 months have prolonged motility > the more medication is absorbed

90
Q

Pancreatic enzymes

A

variable in first 3 months

91
Q

IV Peds Considerations

A

immediately available for absorption into the child’s bloodstream since peripheral circulation is more responsive to environmental changes

92
Q

Infant body weight is _____ % muscle

A

25%

93
Q

Blood flow peds considerations

A

can be unpredictable in young children which can increase or decrease absorption of med

94
Q

Gluteus maximus in infants

A

should be avoided due to potential for damaging sciatic nerve

95
Q

topical absorption in indants

A

much greater due to larger BSA to weight ratio

96
Q

body fluid content in infants

A

Body fluid content 75% of body weight in infants [need higher dose per kg of water-soluble med]

97
Q

body fluid content in > 2 yo

A

Body fluid content 60% of body weight in > 2 yo [need higher dose per kg of water-soluble med]

98
Q

Plasma proteins

A

Preterm and Newborn have lower levels of plasma proteins > more unbound drug circulate

99
Q

blood-brain barrier

A

Blood-brain barrier fully matures at 2 yo > previous immaturity causes barrier to be less selective allowing distribution of medications into CNS and/or lead to paradoxical effects

100
Q

Metabolism in newborn and premature

A

Newborn and Premature infants may not properly metabolize all the medication in a given dose due to immature metabolic enzyme systems in liver

101
Q

Metabolism in older infants, toddlers, preschoolers

A

Older infants, toddlers, and preschoolers metabolize certain drugs more rapidly

102
Q

Renal system pediatrics consideration

A

Newborn renal system is immature with a GFR and less efficient renal tubular function

Adult levels of renal function reached at 1 to 2 yo

103
Q

Urine concentration

A

Infants and young children unable to concentrate urine > medication can circulate linger and reach toxic levels in the blood

104
Q

Too much milk digested by baby

A

Too much milk can cause iron deficiency or anemia due to dilution leading to suppressed bone marrow

105
Q

Breastfeeding

A

Exclusively breastfeed infants for 4 months [preferable 12 months]

106
Q

Solid foods

A

avoid until 4 to 6 months

107
Q

milk for 1-8 years old

A

Children 1-8 years old should drink 2 cups of milk per day [fat free 1-2 yo; low-fat milk > 2 yo]

108
Q

milk for > 9 yo

A

Children > 9 yo should drink 3 cups of fat-free or low-fat milk per day

109
Q

juice intake pediatric considerations

A

limit 4-6 oz per day

110
Q

total daily intake _____% of calories for 2-3 yo

A

30-35%

111
Q

total daily intake ____% of calories for 4-18 yo

A

25-35%

112
Q

prealbumin levels

A

Can send pre albumin in determining nutritional status [ rising = patient receive quality nutrition]

113
Q

how long can an ovum be fertilized

A

5-7 days after ovulation

114
Q

how long can a sperm survive ? remain in fetal tract?

A

24 hrs; 80 hrs

115
Q

Day 10

A

implantation completed

116
Q

Day 21-22

A

heart starts beating

117
Q

Week 8

A

all major organs in place

118
Q

Week 12

A

blood forms in liver and shifts to spleen

fetal gender determined

119
Q

Week 13-16

A

head smaller in portion

quickening fetal movements

120
Q

Week 17-20

A

fluttering fetal movements

vernix caseosa [biofilm covering fetus from exposure to amniotic fluid]

lanugo present

eyebrows and hair appear

brown fat seen in back of neck, sternum and around kidney

121
Q

Weeks 21-24

A

skin transluscent and red

lungs produce surfactant

122
Q

weeks 25-28

A

skin less red

eyes open

blood shifts spleen to bone marrow

123
Q

week 30

A

female fetus has all the ova she will ever need

124
Q

weeks 29-32

A

skin pigmented to race

toenails and fingernails

more subcutaneous fat which increases chance of survival

125
Q

weeks 33-38

A

gaining weight

maturing pulmonary system

testes in scrotum

breasts both enlarged

126
Q

Which is a child more likely to lose, ICF or ECF?

A

ECF

Children have higher percent water in ECF

127
Q

What is a true fever in an infant

A

100.8

128
Q

Define manifestations of dehydration in relation to body weight-
mild?
moderate?
severe?

A

mild: less than 5% of body weight

moderate: 5-10% of body weight

severe: greater than 10% of body weight

129
Q

What does a decreased bicarbonate indicate?

A

an ominous sign to dehydration

as evidenced by high BUN and ketones in urine

BBBicarbonate is known as a BBBase which helps prevent the body from being too acidic&raquo_space; leads to metabolic acidosis

130
Q

What happens to:
potassium
glucose
and urine specific gravity
in dehydration?

A

decreased
decreased
elevated: *** anything higher than 1.020 suggests dehydration

131
Q

What is a sign and symptom of dehydration?

A

** tachypnea, tachycardia, SOB

sunken soft spot
sunken eyes with dark circles
sunken fontanelle spots

132
Q

Dehydration in skin

A

skin tents

133
Q

causes of diarrhea

A

intestinal: shigella, botulism

fungal overgrowth: immunosuppressed!
if been taking abx for > 2 weeks, administer antifungal

intestinal obstruction: torsion of bowels, strictures

134
Q

What to avoid when diarrhea is present

A

juice, gatorade and antidiarrheal since we need to determine cause of diarrhea

135
Q

implements measures to reduce vomiting

A

stay 30 mins upright after feeding

136
Q

most frequent admitting diagnosis in children’s hospital

A

asthma

137
Q

leading cause of acute and chronic illness in children

A

asthma

138
Q

what predisposes children to asthma

A

children’s smaller, narrower airways and decrease elastic lung recoil make them more susceptible to airway obstruction

child’s flexible rib cage and underdeveloped chest muscles and diaphragm lead to exhaustion when respiratory effort increases

139
Q

what happens with asthma as a child grows older

A

it is not outgrown, the severity decreases due to the increased airway diameter, improving diaphragm support and clearance of mucus

140
Q

what is a silent chest

A

a child in severe respiratory distress who is not showing wheezing due to a decrease in air movement

an ominous sign during an asthma episode

**increase in wheezing can be good in that it signals improvement

141
Q

Pulmonary function test using a peak flow meter

A

perform three times in one sitting and record the highest reading

low readings indicate worsening obstruction

142
Q

peak expiratory flow rate (PEFR)

A

for children with chronic asthma

143
Q

spirometry

A

for children older than 5 years

144
Q

how often can you give a short acting beta 2 adrenergic agonist to a child?

A

via a nebulizer or a metered dose inhaler (MDI) as eoften as every 20 mins for 1 hour

ipratropiun bromide can be combined with albuterol in some children with severe excacerbations (older than 12 yo)

145
Q

why is humidified oxygen used?

A

to keep the o2 sat at or greater than 95%

146
Q

status asthmaticus

A

severe asthma exacerbation that is unresponsive to vigorous treatment measures

medical emnergency that can cause respiratory failure and death

147
Q

What is perioral cyanosis

A

blue discoloration of the fingernails indicate that the child needs emergency treatment immediately for asthma

147
Q

exercise-induced asthma

A

can pretreat with SABA before exercise

147
Q

when is emergency asthma management prompted

A

when a peak flow rate that decreases or does not change even after an inhaled beta 2 adrenergic agonist or that is less than 60% of the child’s predicted baseline level or personal best

147
Q

what are oral corticosteroids in relation to asthma

A

potent anti-inflammatory medications that are usually prescribed in short-burst courses of 5-7 days

147
Q

mild persistent asthma

A

symptoms more often than twice per week but less than once a day

PEFR > 80% predicted

148
Q

intermittent asthma

A

symptoms less than or equal to twice per week or only with exercise

infrequent use of bronchodilator (< 2 days a week)

asymptomatic with normal peak expiratory flow rate (PEFR)

148
Q

moderate persistent asthma

A

daily symptoms with daily bronchodilator use

PEFR 60-80% of predicted

149
Q

severe persisent asthma

A

severely limited physical activity

PEFR less than or equal to 60% of predicted for worsening asthma signs and symptoms

150
Q

where is foreign body aspiration commonly seen

A

6 months to 5 years

151
Q

most foreign bodies become lodged in the bronchi.. which side likely

A

the right main bronchus is a more common site than the left main bronchus due to anatomic development (as it is straighter and shorter)

152
Q

signs and symptoms of laryngeal and tracheal obstruction

A

choking, dysphagia, hoarseness, croupy cough, striddor, and possibly dyspnea with cyanosis

153
Q

full obstruction will require

A

the heimlich maneuver (if not been performed already) before the child arrives to the hospital > meaneuver forces the diaphragm upward, which generates increased intrathoracic pressure and results in increased intratracheal pressure that expels foreign body

154
Q

what happens in ARDs

A

breakdown in alveolar-capillary barrier and fluid accumulation in the interstitium and alveoli

155
Q

acute ards

A

capillary congestion and pulmonary edema

156
Q

chronic ards

A

fibrosis of the lungs develop in children who do not recover from the acute stage

157
Q

first priority with a child who inhaled smoke

A

put a NRB mask on child to 100% oxygen

158
Q

clinical manifestations of smoke inhalation

A

singed nasal hair, cough, hoarseness, hemoptysis, soot in sputum, cyanosis, wheezing

159
Q

what is periodic breathing

A

three or more respiratory pauses of longer than 3 seconds with less than 20 seconds of respiration between pauses

160
Q

infant apnea types:
central
obstructive
mixed

A

central: absence of respiratory effort and air movement

obstructive: apparent respiratory efforts without air movement or sound

mixed: absence of respiratory effort and nasal air movement followed by resumption of respiratory effort without air mvoement

161
Q

Bronchopulmonary Dysplasia

aka chronic lung disease of infancy

A

chronic obstructive pulmonary disease that occurs as a result of acute lung injury in some infants who have received supplemental o2 and mechanical ventilation

162
Q

how to prevent bronchopulmonary dysplasia

A

administration of corticosteroids to mother before birth

postnasal surfactant

administration of vitamin A

use of nasal continuous positive airway pressure (cpap) when the infant is intubated as well as after extubation

163
Q

what is the significance of theophylline or caffeine

A

can enhance lung compliance and improve respiratory status by relaxing smooth muscles

caffeine given for apnea

164
Q

what is a good pulmonary function test

A

> 60

165
Q

what is the inflammatory disorder of the nasal mucosa

A

allergic rhinitis

166
Q

symptoms of allergic rhinitis

A

rhinorrhea, itching and paroxysmal sneezing
nasal drainage
itching

allergic salute > indent in nose due to constantly pushing up
allergic shiners > dark circles under eye

167
Q

what lung sounds do you hear if the infection is in the upper airway

A

stridor

168
Q

what lung sounds do you hear if the infection is in the lower airway

A

wheezing, coarse, rhonchi

169
Q

when are viral infections highest

A

during toddler and preschool years

170
Q

what do petechiae (white dots) indicate

A

strep

171
Q

what does tonsilities indicate

A

strep throat

172
Q

what is croup syndrom

A

hoarseness, barking or brassy cough
stridor, respiratory distress

173
Q

age range of croup

A

6 months to 3 years old at highest peak

174
Q

epiglottitis

A

acute, life threatening edema
inflammation of epiglottis and epiglottic folds

175
Q

what are clinical manifestations of people with epiglottitis

A

tripod positioning > drooling

176
Q

what is the treatment with epiglottitis

A

intubation first!
throat and blood cultures > antipyretics > IV abx (of ibuprofen is toradol)

177
Q

what is laryngotracheobronchitis (LTB)

A

croup

178
Q

what is bacterial tracheitis

A

of the upper trachea
typically in older children (5-7 yo)

179
Q

lower airway problems for those
< 3 yo
> 3 yo ??

A

reactive airway disease
asthma

180
Q

what are PPE related to RSV

A

respiratory– gown, mask, eye protection, gloves

181
Q

emergency management is warranted in asthma if

A

trouble with walking or talking
listlessness or weak cry

worsening wheeze, no improvement after bronchodilator, difficulty breathing, discontinuation of play, gray or blue lips or fingernails

182
Q

what is cyrstic fibrosis

A

autosomal recessive
chromosome 7
CFTR protein (checked on sweat test)

r/t increased viscosity of mucous gland secretions

183
Q

when are universal newborn screening (and following) for cystic fibrosis

A

0 days
72 hrs
28 days or once discharged

184
Q

management of cystic fibrosis: GI

A

pancreatic enzyme since they have a pancreatic insufficiency, making them unable to digest food properly

185
Q

what are intrinsic factors related to SIDS

A

genetic predisposition
male gender
permaturity

186
Q

what are extrinsic factors related to SIDS

A

prone sleeping
bed sharing
use of bed clothes or mattresses
infant sleeping on upholstered furniture or adult mattress
prenatal or postnasal exposure to cigarette smoke or alcohol

187
Q

how long should an infant be kept in the parents’ room

A

minimum 6 months to ideally 1 year of age

188
Q

pacifier for SIDS

A

wait a few weeks for breastfeeding to be established before introducing a pacifier

peds/obs (2 decks)

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