exam 1 pp slides & ati Flashcards
is a defect in the heart, great vessels, or persistence of fetal structure after birth
occurs in 4-10 children per 1000 live births
Congenital Heart Disease
after Tonsillectomy when you see frequent swallowing it is a sign of _______
bleeding
Moro reflex:
Disappears by ____ months
3-4 months
lasts 1-2 weeks including; irritability, high fever for more than 5 days, conjunctival hyperemia, red throat, swollen hands and feet, maculo-papular rash on trunk and perineal area, unilateral enlargement of lymph nodes, diarrhea and hepatic dysfunction
is what stage of Kawasaki Disease
Acute stage
reflex where:
Hold them in a semi-sitting position, allow head and trunk to fall backwards ~30 degrees
Newborn symmetrically abducts and extends arms
Fans fingers and forms a C with thumb and index finger
Then adducts the arms to an embrace
Then returns to normal
Moro reflex
Babinski Disappears at __ months
12 months
elevated ESR and antistreptolisin O titer (ASO)
are labs for
Rheumatic Fever
Puberty: average age for girl is __, average age for boy is ___
12
14
Newborn’s weight should be measured ___________
must be done naked for accuracy
With Preschool age children
Average weight=___ lbs at age 3
32 lbs
__ years: well developed gross motor; may ride bike with training wheels
5 years
_____ years: trial and error problem solving (this can lead to injury)
10-12 years
what are the two main allergies of concern for immunization
Neomycin or gelatin
Diagnosed using sweat chloride test.
sweat is 2-5 times the level of sodium and chloride
Cystic fibrosis
PIAGETS stage where
Exhibits egocentrism-inability to understand another’s position
Increasing language skills
Play becomes more socialized
No idea of conservation
Magical thinking
2-7 years: preoperational thinking
Contagious mite infection
Usually contracted by close body contact with infected individuals
The mite will burrow into the skin and deposit eggs.
Then eggs hatch over 30 days and travel to skin (incubation is 1-2 months)
Scabies
ERICKSON stage where
Need to form a sense of trust
Learn to love and be loved
Provide visual stim for active involvement
Infant: trust vs. mistrust (0-1yr)
normal respirations for Newborn to 1 year
30 to 60/min
Relates to pain physically
Is able to perceive of psychological pain
Fears bodily harm and annihilation
May view pain as punishment for wrongdoing
Meaning of Pain and Influence for what age group
7 to 10 years of age
prolonged bleeding
umbilical cord cut
vitamin k injection
circumcision
are all clinical manifestations of
Hemophilia
By __ years: dress and wash self, tie shoes
5 years
Plant leaf that has a poisonous oil causing a delay hypersensitivity response. Trauma to the leaves releases the sap
Poison Ivy
Interventions:
Use OTC medications and follow directions
After washing hair remove nits with fine tooth comb
Wash linens, hats, combs and anything that has come in contact with the head
Do not share clothing, hats towels, and hair care items
Pediculosis Lice
9.5-11 is ____ IDA
mild
Prepubescence Typically occurs during pre-adolescence, varying in ages from _____(girls usually about 2 years earlier than boys)
9-12
Chronic inflammatory lung disorder with airway obstruction that can be partially or completely reversed, also includes increased airway responsiveness to stimuli
Most common chronic disorder that affects children
Asthma
normal respirations for 2 to 6 years:
21 to 25/min
Vaculitis (inflammation) of the small vessels that affects children with the mean age of 6 years old.
Etiology unknown
Treatment is supportive care
Henoch-Schönlein Purpura (HSP)
Methylxanthines:
Theophylline po- very rarely used
are used for what?
Daily Control Medications for asthma
___+ years=can give consent
__+ years=can give consent for reproductive health only (IL)
18 years
13 years
normal respirations for 6 to 12 years:
19 to 21 /min
Size Shape Type Location Warmth Color
Distribution
Linear
circular
general
Dry or oozing
should all be considered when assessing
rash
with cyanotic Congenital Heart Disease If a VSD or ASD are present, the right sided pressure exceeds the left resulting in ____________
right to left shunt
Permanent teeth
Cognitive development
Prepubescence
are all common with what age group
school age
Coughing
Wheezing – expiratory that can become progressive to obstruction with no air movement heard
SOB
Tachypnea
Prolonged expiration
Flaring, retractions, head bobbing
Anxiety
Fatigue – increases with hypoxia
are all clinical manifesations of _______
Asthma Exacerbation
Crackles or rhonchi
Fever
Chest pain
Cough
are clinical manifestations of
Pneumonia
Palmar disappears at ____ months
Plantar disappears at __ months
3-4 months
8 months
By __ months, plays simple games (Peak-a-boo and So big) as well as show emotions (ie anger jealousy, fear, hugs, kisses)
12 months
Newborn’s Doubles birth weight by ____ months
5-6 months
for toilet training
Sphincter control: Retain urine: for at least \_\_ hours Bowel control: ~\_\_ months Day time control: ~ \_\_ years Night control: ~ \_\_ years Must be aware of the act of elimination
Sphincter control: ~ when able to walk Retain urine: for at least 2 hours Bowel control: ~30 months Day time control: ~ 2 years Night control: ~ 3-4 years Must be aware of the act of elimination
Corticosteroids:
Methylprednisolone, prednisone, prednisolone – oral/IV/IM
Important to finish dosing, will be weaned most likely
are used for what?
Rescue Medications for asthma
___ months: ~300 word vocabulary, verbalizes need for toileting, food and drink
24 months
Continued weight gain and growth
Improved gross and fine motor
Self care acts
Socialization
are all common with what age group
Preschool
Age __:may count correctly but poor mathematic number concept
Age 4
Assess stool for steatorrhea – excessive stool fat.
Assess for failure to thrive due to malabsorption
Often these children will have distended abdomens with thin extremities
Assess for appetite as they may have a large appetite, but their body is unable to absorb large amounts of food
Assess for rectal prolapse
are all assment techniques for ______
Cystic Fibrosis (GI system)
Varies based on degree of illness and respiratory distress.
Outpatient therapy (not in RD) is oral antibiotics (unless viral), rest, pain and fever treatment and follow up with instructions on when to seek immediate help
Inpatient therapy includes antibiotics IV, and supportive care
Oxygen, IV fluids, fever management, rest and monitoring
are all included in the treatment plan for
Pneumonia
what age should the inintial immunization of DTaP be adminsterd
2 months
should iron be administerd with or without food
empty stomach
By _____ years should be treated as an adult
15-16 years
one way to treat PDA and to get it to close is ____
NSAID
4 clinical manifestations of Acyanotic Congenital Heart Disease
Increased Pulmonary Blood Flow
increased HR
increased RR
increased metabolic rate
with toddlers is growth linear or step like
step like
what age should the inintial immunization of IPV be adminsterd
2 months
Almost no head lag at _ months (should be no head lag by _ months)
4, 5 months
By __ months: develop object permanence, can wave bye-bye
10 months
With Preschool age children
Height gain __ inches per year
3 inches
Tonic Neck (also called fencing reflex) disappers at what age?
Disappears at 3-4 months
Characterized by a bright red maculopapular rash in the diaper area
Causes can be:
clothing dye, laundry detergent, body soap, bubble bath, tight clothes, wool or rough clothing, and irritation from a soiled diaper
Contact Dermatitis:
Diaper Rash
Rhinitis Mild fever Malaise Anorexia for 2-3 days Barking cough and hoarseness Child may appear restless, anxious may have inspiratory stridor Retractions/Respiratory DistresS
are all clinical manifestations of
Croup
the PCV should be given __ times
5 times
2 months, 4 months, 6 months, 12-15 months, 2-6 years
Step-like growth Improved coordination Rapid expansion of sensory and language development Importance of play Sibling rivalry Temper tantrums Regressive behavior Toilet training
are traits of a __________
Toddler
ERICKSON stage where
Learns what kind of person they will be
Adjust to new body image (puberty-rapid physical changes)
Seek emancipation from parents
Experiments with different roles
Peer group very important
Provide for adolescent to discuss feelings
Adolescent: identity vs. role confusion (12-18yr)
ERICKSON stage where
Learns independence
Makes decisions for self
Offer simple choices
Praise decision making
Toddler: autonomy vs. shame (1-3yr)
For Bronchiolitis/RSV
Prophylaxis: _______ for ex-preemies or at risk infants
once a month IM injection during the season for passive immunity
Synagis
nausea, emesis, anorexia, abdominal pain, diarrhea, fatigue, drowsiness, muscle weakness.
are signs of
digoxin toxicity
normal respirations for 12 years and older:
16 to 19/min
what age should the inintial immunization of Hep A be adminsterd
12-23 months
with males
Facial and axillary hair ~ 2 years after pubic hair first appears (usually between ______ years old)
10-15 years
reflex where
Suspend in horizontal prone position and suddenly thrust downward
Hands and fingers extend forward
Parachute
ERICKSON stage where
Basic problem solving
Initiative-demonstrated when a child formulates and carries out a plan of action
Preschool: initiative vs. guilt (3-6yr)
HPV, Pertussis is what kind of vaccination
and can be administered
Recombinant vaccine:
IM
Newborn’s Starts with responding to stimuli, smiles around __ months
2 months
____ months: runs clumsily, walks up stairs holding hands, builds a tower of 3-4 cubes
18 months
the rotavirus should be given __ times
3 times
2 months, 4 months, 6 months
___________ in a child causes bradycardia that will lead to cardiac arrest if not reversed.
Hypoxia
what age should the inintial immunization of influenza be adminsterd
between 6 months - 6 years
infection with fungus
can be in hair, trunk, groin, foot areas
treated with antifungal
tinea
Anorexia Anemic Constipated Nausea and vomiting Dark line in gum
are all clinical manifestation of
Lead Poisoning
8-9.4 is ________ IDA
moderate
___ months: understands simple commands
15 months
priority intervention for EpiglotTitis is to ____
prep for intubation
Caused by a gram negative Bacteria
Starts as upper respiratory disease then worsens with a prolonged coughing and crowing or whooping upon inspiration that can last 4-6 weeks
Coughing can induce cyanosis, emesis and large amounts of secretions
Complications can be pneumonia, hemorrhage and seizures
Pertussis
Rhinitis Cough Tachypnea Grunting Lethargy Poor feeding Wheezing Prolonged expiratory phase Decreased air entry Retractions Apnea Spells Low grade fever early in infection
are all clinical manifestaions of ________
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Rotaovirus is what kind of vaccination
and can be administered
Live Oral
oral
MMR Varicella is what kind of vaccination
and can be administered
Live virus vaccine:
SQ
A yeast-like fungus that is most often found in the GI tract, skin and vagina
It grows most often in moist warm areas
Can result from oral antibiotic therapy and hyperglycemia
Candidiasis or Thrush
infants with RR >__ should not be fed
> 60
Coxsackievirus is ________ isolation
contact
____ months: up and down stairs, 2 feet on each stair, turns pages of a book one at a time
24 months
Play is the work of childhood
It magnifies physical and psychosocial development
Parallel play at this stage(will play with other kids but will be doing their own thing)
Toy safety (must keep this in mind in the hospital environment as well)
are all common with what age group
toddler
With Bronchopulmonary Dysplasia (BPD)
more than 30% O2 at 36 weeks
Severe:
the MMR should be given __ times
2 times
12- 15 months, 4-6 years
when you receive antibodies – can be passed in utero, in breastmilk, immunoglobulin through IV
passive
reflex where:
Touch/stroke cheek along side of the mouth
Use nipple during breast feeding
Turns head towards nipple
Rooting
hypothermina for a newborn is a sign of ________
infection
Caused by RNA Virus
droplet and contact
starts as discrete red rash
vacciene prevention
Rubella
German measles
chest PT postural drainage Nebulizer care cpt vest Mucolytics – pulmozyme, hypertonic saline exercise transplant
are all interventions for _____
Cystic Fibrosis (respiratory )
Rooting disappears at what age
Disappears at 3-4 months
Tetanus is what kind of vaccination
and can be administered
Toxoid:
IM
Refinement of coordination Visual acuity achieves 20/20 by now this is when learn what they are good at have best friend have favorite subject
are all common with what age group
school age children
what age should the inintial immunization of HIb be adminsterd
2 months
Complete head lag at _ month
1 month
___ years: use of reasoning and understanding
9-10 years
Newborn’s Triples birth weight by __ year
1 year
__ years: skip and hop on 1 foot, tie shoes, throw ball over head, draw a stick figure with 3 parts
4 years
Temper tantrums
Normal behavior for this age group but can be quite difficult to deal with for parents and care givers
Important not to “give-in” during a temper tantrum
are all common with what age group
toddler
Startle reflex Disappears by __ months
4 months
PIAGETS stage where
Think in abstract terms Draw logical conclusions Make hypothesis and test them Adaptable and flexible Cannot predict long term consequences
12+ years: formal operational thinking
6-8 weeks: child will appear normal but lingering signs of inflammation may be present
is what stage of Kawasaki Disease
Convalescent stage
palpable purpura, joint pain, colicky abdominal pain, GI bleeding with blood in stool, and hematuria.
are clinical manifestations of
Henoch-Schönlein Purpura (HSP)
Diagnostic Testing for Iron Deficiency Anemia
Hemoglobin level
normal heart rate for newborn
80-180
Inflammation of salivary glands
orchitis (swelling of testicles), encephalitis
Most contagious 1-2 days before the swelling and up to 9 days after
Contact and droplet isolation
mumps
