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CHILDRENS > EXAM 2 > Flashcards

EXAM 2 Flashcards

1
Q

Describe the SHARE acronym for shared decision making

A

SEEK pt participation

HELP you pt explore tx options

ASSES pt values/preferences

REACH a decision w/ your pt

EVALUATE pt’s decision

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2
Q

define Cognitive Impairment

A

Cognitive impairment” (CI) is a general term that encompasses
any type of mental difficulty or deficiency
Used synonymously with “intellectual disability”
Diagnosis
◦ Made after a period of suspicion by family or health
professionals
◦ In some instances, made at birth

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3
Q

To be Dx w/ an Intellectual disability, you must…

A

Have an IQ of 70-75 or below

Impairment in 2 of 10 adaptive skills

Younger than age 18 at the time of diagnoses

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4
Q

Diagnosis of mildly impaired characterizes __% of the
population with cognitive impairment

A

85

Can be in school and become educated

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5
Q

Diagnosis of moderately impaired characterizes __% of the population with

A

10

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6
Q

what are two Measures to Prevent Cognitive
Impairment

A

rubella immunization

folic acid supplementation

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6
Q

What is the Most common
chromosome
abnormality

A

Down Syndrome

slanted, upturned eyes

small ears

flat nose bridge

short neck

square head

tongue poking out

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6
Q

What are down syndrome causes

A

Extra chromosome 21 in 95% of cases

Maternal age
◦ Age 35: risk is 1 per 350 births
◦ Age 40: risk is 1 per 100 births

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6
Q

What are some physical problems children with down syndrome may experience

A

◦ Congenital heart disease
◦ Hypothyroidism
◦ Leukemia
◦ Atlanto-axial instability @ c-spine

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7
Q

The second most common genetic cause
of cognitive impairment after Down
syndrome

A

Fragile X Syndrome

Large ears, long face, big forehead, intellectual disability

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8
Q

Fragile X Syndrome is caused by

A

Caused by abnormal gene on the
lower end of the long arm of the X
chromosome
14

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9
Q

Fragile X Syndrome:
Classic Behavioral Features

A

Mild to severe cognitive impairment

Delayed speech and language

Hyperactivity

Hypersensitivity to taste, sounds, and touch

Autistic-like behaviors

Aggressive behaviors

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9
Q

Fragile X Syndrome:
Therapeutic Management

A

Tegretol/Prozac for behavioral control

Stimulants for hyperactivity (similar to management of attention
deficit/hyperactivity disorder)

Referral to early intervention program

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10
Q

Slight to moderately severe hearing impairment

A

Residual hearing with the use of an aid

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11
Q

Severe to profound hearing loss

A

Cannot process linguistic information

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12
Q

What are two common hearing impairment causes

A

chronic ear infections and environment

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13
Q

Conductive hearing loss affects the…

A

middle ear

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14
Q

Sensorineural hearing loss reflects damage to the…

A

inner ear or auditory
nerve

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15
Q

Mixed conductive-sensorineural loss: interfers with…

A

transmission of sound

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16
Q

what are Manifestations of hearing impairment in Infancy

A

Lack of startle reflex

Absence of reaction to auditory stimuli

Absence of well-formed syllables by age 11 months

General indifference to sound

Lack of response to spoken word

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17
Q

what are Manifestations of hearing impairment in childhood

A

If not detected in infancy, identified upon entry into school

Abnormalities in speech development

Learning disabilities

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18
Q

partially sighted children have a visual acuity of…

A

20/70 to 20/200

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19
Q

legally blind children have a visual acuity of…

A

Acuity of 20/200 or poorer

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20
Q

what are some disorders that can cuase visual impairment in children

A

◦ Sickle cell disease
◦ Juvenile rheumatoid arthritis
◦ Tay-Sachs disease

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21
Q

Suspect visual impairment in a child of any age when…

A

pupils do
not react to light

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22
Q

The Most common congenital malignant intraocular tumor in children is…

A

Retinoblastoma

Manifestations
◦ WHITE EYE REFLEX
◦ Strabismus
◦ Blindness

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23
Q

Describe Esotropia

A

eye looks to center

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24
Q

Describe Exotropia

A

eye looks to outside

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25
Q

Describe Hypertropia

A

eye looks up

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26
Q

Describe Hypotropia

A

eye looks down

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27
Q

Children with autism display uncharacteristic behaviors in regards to..

A

◦ Socialization
◦ Communication
◦ Behavior
◦ Difficulty with eye and body contact
◦ Language delay
Diagnosis often delayed until age 2-3 years

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28
Q

Although autism isn’t curable, doing things like ___ will help the pt manage daily activities

A

◦ Attempt behavior modification
◦ Provide a structured routine
◦ Decrease unacceptable behavior

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29
Q

______ _____ _ ________ is good source of information for parents with autisitc children

A

Autism Society of America

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30
Q

What are indications a child may have ADHD or another learning disorder

A

Developmentally inappropriate inattention, impulsivity, and
hyperactivity

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31
Q

What do you test to determine if a kid had ADHD/LD

A

IQ
Hand-eye coordination
Visual and auditory perception
Comprehension
Memory

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32
Q

Name the three types of medications used for ADHD

A

Stimulants, Tricyclic Antidepressants, and Norepinephrine transport inhibition

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33
Q
A

◦ Dexedrine
◦ Methylphenidate (Concerta, Metadate, Ritalin)
◦ Dextroamphetamine (Adderall)
◦ Dexmethylphenidate (Focalin)

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34
Q

Examples of tricyclic antidepressants used to treat ADHD

A

◦ Clonidine
◦ Guanfacine (Intuniv)

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35
Q

Examples of Norepinephrine transport inhibition used to treat ADHD

A

◦ Atomexatine (Straterra)

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36
Q

The Upper respiratory tract anatomically consists of the…

A

▶ Oronasopharynx, pharynx
▶ Larynx, upper trachea

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37
Q

The Lower respiratory tract anatomically consists of the…

A

▶ Lower trachea, bronchi
▶ Bronchioles, alveoli
3

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38
Q

The nurse is discussing sexuality with the parents of an adolescent girl with moderate cognitive impairment. What should the nurse consider when dealing with this issue?

A

Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.

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39
Q

What are the Five stages of coping (for Children with Special Needs)

A

Develops competence and optimism

Feels different and withdraws

Irritable, moody, acting out

Complies with treatment
Seeks support

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40
Q

T/F: Alway pair a bolus feed through a G/J tube with a pacifier

A

True.

sucking = as belly get full, it helps the infant realize satiation

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41
Q

Describe a 6 month old and younger’s Understanding and Reaction to Death

A

unaffected

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42
Q

Describe a 6 month old and older’s Understanding and Reaction to Death

A

affected by loss

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43
Q

Describe a toddler’s Understanding and Reaction to Death

A

egocentric, more affected by change in lifestyle

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44
Q

Describe a preschool age child’s Understanding and Reaction to Death

A

magical thinking, powerful thinking, death isn’t permanent- just sleeping

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45
Q

at what age do children develop permanence that death is final

A

around age 9

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46
Q

Describe a School age child’s Understanding and Reaction to Death

A

seen as a punishment or evil thing

once they turn 9 they have an adult understanding of death

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47
Q

Can a child designate themselves as a DNR/DNI?

A

A DNR may be placed by a physician’s who has the consent of the patient or, if the patient is a minor or is otherwise incapable of making an informed decision regarding consent for such an order, upon the request of and with the consent of the person authorized to consent on the patient’s behalf.

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48
Q

How should you act after a patient’s family begins to mourn terrible news

A

Stay with family

Sit quietly

Avoid judgmental statements, rationalizations, or artificial consolation

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49
Q

Name 5 infectious agents that cause pediatric URIs

A

Respiratory syncytial virus (RSV)

Group A β-hemolytic streptococci

Staphylococci

Haemophilus influenzae

Chlamydia trachomatis

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50
Q

At what age is there an increase in Mycoplasma pneumoniae and β-hemolytic streptococcal infections

A

5 years and up

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51
Q

How long do maternal antibodies last for

A

0-3 months

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52
Q

what seasons have the most URIs/RSV

A

winter and spring

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53
Q

Which URI is most common in fall and winter

A

Mycoplasmal infections

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54
Q

Infection-related asthma: more frequent in ___ weather

A

cold

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55
Q

__mo – __yr respond more to resp infections

A

6mo – 3 yr

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56
Q

Describe symptoms of Meningism found in children with an URI

A

Meningism is defined as signs of meningeal irritation occurring without other features of meningitis or noninflammatory meningeal involvement (eg, in a patient with high-grade fever unrelated to a central nervous system [CNS] disorder).

Neck stiffness, back pain when lying and flexing leg/chin upwards

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57
Q

What symptoms could mean something more serious in children with a URI

A

Deterioration

Increase respiratory distress

Increase RR

increase HR

Worsening hypoxia

Poor perfusion

Decrease LOC

Lethargy

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58
Q

A child should be voiding at least (_ml/kg/h <__kg and __ml/h >__kg)

A

Voiding (1ml/kg/h <30kg and 30ml/h >30kg)

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59
Q

How can you make a child with a URI more comfortable

A

Moisturized air
FluiNose drops/throat garles
Nasal aspirator/bulb syringe
Vapor rubs (>2 yo)
Teach children how to cough/sneeze
Controlling fever important for comfort

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60
Q

Name signs/sx of ACUTE STREPTOCOCCAL PHARYNGITIS in children

A

skin (impetigo/pyoderma)

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61
Q

What infection can cause rheumatic fever (inflammatory disease of the heart, joints & CNS) & acute glomerulonephritis

A

Group A β-hemolytic streptococcal infection

62
Q

What are the symptomatic differences between a strep and viral URI

A

STREP:
Sudden onset
Fever: 103-104
c/o Sore throat, erythema, exudate, tonsillitis, abd pain, HA
Positive RST, high elevation of WBC

VIRAL
Gradual onset
Low grade fever
c/o slight sore throat, less erythema, hoarseness, cough, rhinitis
Negative RST, slight elevation of WBC

63
Q

Continuous swallowing in children could be a sign of

A

bleeding from tonsillectomy

Hemorrhage unusual but could occur btwn 5-10 days

64
Q

How do you cure tonsilitis

A

Tonsillectomy and adenoidectomy

65
Q

What medication can you give children with the flu

A

Oseltamivir all ages, start within 2 days onset of s/s

66
Q

OTITIS MEDIA OM is the inflammation of the…

A

middle ear without infectious process present

67
Q

OTITIS MEDIA AOM is the inflammation of the…

A

middle ear with rapid onset of S&S of acute infection (ie, fever & otalgia)

68
Q

OTITIS MEDIA OME is the inflammation of the…

A

middle ear space without symptoms of acute infection

69
Q

OTITIS MEDIA is most common in what age group

A

first 2 years of life

70
Q

When would you consider TM tubes +/- adenoidectomy

A

> 3 episodes in <6 months

71
Q

What age group does croup affect the most

A

Generally affects children <5 years of age (3 months – 3 years)

72
Q

Croup is Most often caused by

A

H. influenzae type B

73
Q

What are the two famous symptoms of croup

A

Inspiratory stridor, seal like cough

74
Q

How do you treat croup

A

Maintaining the airway
Maintain hydration, orally or intravenously
Nebulized mist with supplemental O2
Nebulizer treatments
Epinephrine
Steroids

75
Q

Describe ACUTE SPASMODIC LARYNGITIS

A

Also known as “spasmodic croup”
Paroxysmal attacks of laryngeal obstruction
Occurs chiefly at night
Inflammation: mild or absent
Most often affects children 1-3 years of age
Therapeutic management
Similar to that for infectious croup
Hot shower running in bathroom

76
Q

BACTERIAL TRACHEITIS has similar sx to croup (and is often a result of it) expect for…

A

Thick, purulent secretions that result in respiratory distress

Vigorous management
Humidified oxygen
Antipyretics
Antibiotics
Possible need for intubation
Mechanical ventilation

77
Q

Describe ACUTE EPIGLOTTITIS

A

A MEDICAL EMERGENCY

Might lose their airway

Sx include Sore throat, pain, tripod positioning
Drooling, difficulty swallowing
Inspiratory stridor, mild hypoxia, distress
Increased HR & RR. Substernal, suprasternal, intercostal retractions. Nasal flaring & increased restlessness

78
Q

T/F: Cartilaginous support not fully developed until adolescence

A

True

79
Q

The most frequent cause of hospitalization for those under 2 years is

A

RESPIRATORY SYNCYTIAL VIRUS

80
Q

T/F: Risk factor for asthma later if severe RSV infection in first year of life

A

True

81
Q

What medication can you take for RSV

A

Ribarvirin – inhaled antiviral (controversial)
** Synagis prevention for high risk infants

82
Q

Whooping cough is caused by

A

Bordetella pertussis

83
Q

TB test 5mm means

A

recent contact w/ TB positive person

84
Q

TB test 5mm means

A

Has had TB in the past 5 years but is asymptomatic

85
Q

TB test 5mm means

A

They have TB

86
Q

SX FOREIGN BODY ASPIRATION include

A

dyspnea, cough, stridor, hoarseness, cyanosis

87
Q

Name some substances that can cause severe aspiration pneumonia if aspirated

A

Hydrocarbons, lipids
Solvents
Talcum powder

88
Q

what are risk factors for asthma

A

Atopy
Heredity
Gender
Smoking exposure
Maternal smoking in pregnancy
Ethnicity
Low birth weight
Being overweight

89
Q

What is considered when deciding the classification of Asthma?

A

Symptom frequency day
Nighttime symptoms (waking)
PEF
Use of rescue inhaler (short acting b agonist)
Interference of normal activity

90
Q

CLASSIFICATION OF ASTHMA SEVERITY
IN CHILDREN AGED 5 YEARS & OLDER Step 1:

A

mild, intermittent asthma

91
Q

CLASSIFICATION OF ASTHMA SEVERITY
IN CHILDREN AGED 5 YEARS & OLDER Step 2:

A

mild, persistent asthma

92
Q

CLASSIFICATION OF ASTHMA SEVERITY
IN CHILDREN AGED 5 YEARS & OLDER Step 3 or 4:

A

moderate, persistent asthma

93
Q

CLASSIFICATION OF ASTHMA SEVERITY
IN CHILDREN AGED 5 YEARS & OLDER Step 5 or 6:

A

severe, persistent asthma

94
Q

Name 6 DRUG THERAPies FOR ASTHMA

A

Albuterol, metaproterenol, terbutaline
Long-term bronchodilators (salmeterol [Serevent])
Theophylline: monitor serum levels
Leukotriene modifiers
Cromolyn sodium

95
Q

What is Peak Flow Rate

A

The maximum flow rate that can be generated during a forced expiratory maneuver with full inflated lungs (L/min)

96
Q

What is the “green zone” of Peak Flow Rate

A

80-100% of personal best, avoid things that make it worse

97
Q

What is the “yellow zone” of Peak Flow Rate

A

50-80% of personal best, take medication to relieve episodes

98
Q

What is the “red zone” of Peak Flow Rate

A

<50% of personal best, call MD or seek care immediately

99
Q

describe STATUS ASTHMATICUS

A

Medical emergency
Respiratory failure and death if untreated
Continuation of respiratory distress despite vigorous therapeutic measures
Concurrent infection in some cases
Therapeutic intervention
Improving ventilation
Pharmacologic agents

100
Q

what are 3 signs of chronic allergy

A

Allergic salute 🡪 transverse crease on upper nose
Dark circle under eyes
Post nasal drip

101
Q

Describe the signs of CYSTIC FIBROSIS

A

Increased viscosity of mucous gland secretions
Elevation of sweat electrolytes
Increase in enzymatic constituents of saliva
Autonomic nervous system abnormalities
Delayed puberty in girls
Sterility in boys
Parents’ report: child’s skin tastes “salty”
Dehydration
Hyponatremic/hypochloremic alkalosis
Hypoalbuminemia

102
Q

How do you diagnose cystic fibrosis

A

Sweat chloride test
Newborn screening
DNA identification of mutant genes
Abnormal measurement of nasal potential difference

103
Q

Describe the symptoms of CYSTIC FIBROSIS

A

Wheezing respiration, dry nonproductive cough
Generalized obstructive emphysema
Patchy atelectasis
Cyanosis
Clubbing of fingers and toes
Repeated bronchitis and pneumonia

Meconium ileus
Distal intestinal obstruction syndrome
Excretion of undigested food in stool; increased bulk, frothiness, and foul odor
Wasting of tissues
Prolapse of the rectum

104
Q

Describe the long term effects of cystic fibrosis

A

Chronic hypoxemia: causes contraction/hypertrophy of muscle fibers in pulmonary arteries/arterioles
Pulmonary hypertension
Cor pulmonale
Pneumothorax
Hemoptysis
Eventually pancreatic fibrosis occurs;
diabetes mellitus may result
Focal biliary obstruction results in multilobular biliary cirrhosis

Pancreatic enzyme deficiency
Sweat gland dysfunction
Failure to thrive
Increased weight loss despite increased appetite

105
Q

How do you manage cystic fibrosis

A

Airway clearance therapies
Bronchodilator medication
Physical exercise
Aggressive treatment of pulmonary infections
Aerosolized antibiotics
Home intravenous antibiotic therapy
Replacement of pancreatic enzymes
High-protein, high-calorie diet: as much as 150% recommended dietary allowance (Supplemental Vit A, D, E, K)
Relief of intestinal obstruction (ileus)
Reduction of rectal prolapse
Treatment of chronic gastrointestinal reflux

106
Q

Describe situations in which a pt would need more fluid

A

Fever
Vomiting, diarrhea
High-output kidney failure
Diabetes insipidus
Diabetic ketoacidosis
Burns
Shock
Tachypnea
Radiant warmer (preterm infant)
Phototherapy (infants)
Postoperative bowel surgery

107
Q

Describe situations in which a pt would need less fluid

A

Heart failure
Syndrome of inappropriate antidiuretic hormone
Mechanical ventilation
After surgery
Oliguric renal failure
Increased intracranial pressure

108
Q

If a pt has a fever, they require __% more fluids

A

15

109
Q

how do you calculate fluids for an adult

A

30 ML/KG

110
Q

Describe isotonic dehydration

A

Water & salt are lost in equal amounts
This is the primary form of dehydration in children
Reduction of plasma volume and circulating blood volume
Shock greatest risk (hypovolemic)

111
Q

Describe hypotonic dehydration

A

Loss of electrolytes (electrolyte deficit exceeds water deficit)
ECF loss is greater = physical signs more severe
Na <130 mEq/L

112
Q

Describe hypertonic dehydration

A

Loss of water (larger loss of water or larger intake of electrolytes)
Most dangerous 🡪 specific fluid therapy

113
Q

Acute ________ is leading cause of illness in children < 5 years of age

A

diarrhea

Of all deaths in developing countries, 24% are related to diarrhea & dehydration

114
Q

Gastroenteritis affects the…

A

stomach and intestines

115
Q

enteritis affects the…

A

Small intestine

116
Q

colitis affects the…

A

Colon

117
Q

enterocolitis affects the…

A

Colon and intestines

118
Q

What are the 5 types of diarheas

A

acute, infectious, chronic, nonspecific, intractable diarrhea of infancy

119
Q

Therapeutic Management of Diarrhea

A

Low sodium broth
Apple juice (not great since high CHO and low electrolyte) and water 1:1
Pedialyte or other ors
Popsicles (Pedialyte popsicles)

No BRAT little nutritional value and high CHO, low electrolytes

120
Q

First meconium should be passed within __-___ hours after birth

A

24-36

121
Q

If First meconium should be passed within 24-36 hours after birth, you should suspect one of these three things…

A

Intestinal atresia, stenosis
Hirschsprung disease, hypothyroidism
Meconium plug, meconium ileus (CF)

122
Q

What re 4 interventions for Constipation during Infancy

A

INTERVENTIONS:
PRUNE(S)/ JUICE
INCREASE WATER INTAKE
GLYCERIN SUPP.

123
Q

Describe Hirschsprung Disease

A

Also called “congenital aganglionic megacolon”
Congenital anomaly
Mechanical obstruction from inadequate motility of intestine
Incidence: 1 per 5000 live births; more common in boys and in children with down syndrome
Absence of ganglion cells in colon

123
Q

Describe Encopresis

A

inappropriate passage of feces, often with soiling

124
Q

What are the two stages of Therapeutic Management for Hirschsprung Disease

A
  1. Temporary ostomy
    Second stage: “pull-through” procedure
125
Q

A Green, bilous vomit may be an indication of

A

bowel obstruction

126
Q

Forceful vomiting is otherwise known as

A

pyloric stenosis

127
Q

Headache with vomiting may be an indication of

A

CNS or metabolic disorder

128
Q

Abd pain & vomit may be an indication of

A

appendicitis, pancreatitis, PUD

129
Q

When Do We Worry about vomiting?

A

BRB
COFFEE GROUNDS
ABSENCE OF NAUSEA
MIDDLE OF THE NIGHT OR 1ST THING IN THE AM
FTT

130
Q

Treatment of Gastroesophageal Reflux (GER) in infants

A

THICKEN FEEDS
SMALLER, FREQUENT MEALS
H2 ANTAGONISTS (ZANTAC) & PPI’S (PREVACID, NEXIUM)
KEEP UPRIGHT AFTER MEALS

131
Q

Signs of Acute Appendicitis

A

McBurney point (tenderness from umbilicus to RLQ)

132
Q

Inflammatory Bowel Disease (IBD) includes these two diseases

A

ulcerative colitis and crohn’s disease

133
Q

What dietary changes should you consider with Inflammatory Bowel Disease (IBD)

A

High protein high calorie diet (well balanced)
MVI, iron, folic acid

134
Q

What are the difference in symptoms between ulcerative colitis and crohn’s disease

A

ulcerative colitis: rectal bleeding, diarrhea, no pain, some anorexia/weight loss, and mild rash/joint pain

crohns disease: no rectal bleeding, severe pain, diarrhea, severe anorexia/weight loss/growth retardation, anal lesions, fistulas, and mild rash/joint pain

135
Q

how is Hepatitis A transmitted

A

fecal oral route

136
Q

describe BILIARY ATRESIA

A

childhood disease of the liver in which one or more bile ducts are abnormally narrow, blocked, or absent. It can be congenital or acquired

137
Q

CLEFT LIP AND CLEFT PALATE type A

A

only affects lip

138
Q

CLEFT LIP AND CLEFT PALATE type B

A

affects lip and palate

139
Q

CLEFT LIP AND CLEFT PALATE type C

A

y shaped, affects two parts of lip and one lie centered through palate

140
Q

CLEFT LIP AND CLEFT PALATE type D

A

only affects palate

141
Q

SURGICAL CORRECTION OF CLEFT LIP

A

Closure of lip defect precedes correction of the palate
Performed when patients are 2-3 months of age
Protect suture line

142
Q

SURGICAL CORRECTION OF CLEFT palate

A

Typically performed when patients are 6-12 months of age

143
Q

describe Esophageal atresia

A

failure of esophagus to develop as a continuous passage

144
Q

describe TRACHEOESOPHAGEAL FISTULA (TEF)

A

Tef: failure of the trachea to separate into a distinct structure

145
Q

MANAGEMENT OF TEF

A

Maintenance of a patent airway
Prevention of pneumonia
Gastric or blind pouch decompression
Supportive therapy
Surgical repair

146
Q

concerns/types of HERNIA

A

Danger of incarceration/strangulation
Types
Diaphragmatic
Abdominal wall
Inguinal canal

147
Q

describe **HYPERTROPHIC PYLORIC STENOSIS

A

Constriction of pyloric sphincter with obstruction of gastric outlet

148
Q

describe * INTUSSUSCEPTION

A

Telescoping or invagination of one portion of intestine into another
Most common cause of intestinal obstruction in children aged 3 months to 3 years
Occasionally due to intestinal lesions (10%)
Cause is often unknown

Red currant jelly stool

149
Q

describe the difference between MALROTATION AND VOLVULUS

A

Malrotation: abnormal rotation of intestine around the superior mesenteric artery during embryologic development

Volvulus: twisting of intestine around itself, thereby compromising blood supply to intestines

May cause necrosis, peritonitis, perforation, and death

150
Q

Obese: generally considered when body mass index (bmi) is in ___th percentile for age, gender, and height

A

> 95th

151
Q

Overweight: generally considered when bmi is between the __th and 95th percentile

A

85

152
Q

How can nurses teach cognitively impaired patients

A

these children can learn to discriminate if the cues are presented in an exaggerated, concrete form and if all extraneous stimuli are eliminated.

demonstration is preferable to verbal explanation, and learning should be directed toward mastering a skill rather than understanding the scientific principles underlying a procedure.

they need simple, one-step directions (task analysis, see how to break a task down)

positive reinforcement to encourage the accomplishment of specific tasks or behaviors.

153
Q

you get hep a from

A

food and water. you can get post-exposure immunoglobins to treat. IGM means active infection, IGG means antibodies, no infection. prevent w/ vaccine and handwashing

154
Q

describe hep b

A

get it from iv drug use, birth, and sex. HBSnG postive means active infection and can spread. antibodies indicate immunity, no infection

155
Q
A

CHILDRENS (8 decks)

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