Exam 2 Flashcards
How do you calculate body mass index
weight/height/height x 703
Which fontanelles close first and when
posterior
2 months
Which fontanelles close last and when
front
7-18 months
What are some red flags to indicate possible physical child maltreatment
burns, rib fractures, lesions and marks, head injuries
What are some red flags to indicate possible emotional child maltreatment
developmental delayed
bed wetting w/o medical reason
depression/anxiety
overly compliant
What are some red flags to indicate possible sexual maltreatment of a child
hypersexual awareness, inflamed genitals, STI’s, fear of perpetrator
What is PICA
eating disorder of nonfood items (dirt, crayons, paper)
at risk for poisoning
higher risk from 2-6 years, adolescence, and pregnancy
Condition characterized by refusal to
maintain a healthy body weight because of a disturbance in perception of the size or appearance of the body
Anorexia nervosa
What are key features of anorexia nervosa
self induced starvation
relentless need to be thin
medical s/s due to starvation
BMI less than 85% of expected weight
Condition where there is recurrent and episodic binge eating and purging by vomiting/exercise
Bulimia nervosa
What are signs of Bulimia nervosa
teeth erosion from stomach acids
Russell sign- scars on hand from inducing vomiting
esophageal tears
What are red flags of a possible substance abuse in adolescents
increased absenteeism, declining grades, diagnosed hepatitis, STIs, HIV
Vaccinations needed between 4-6 years old
DTap dose 5
Polio dose 4
MMR dose 2
Varicella dose 2
Vaccinations needed between 11-12 years old
Tdap
HPV (2 doses over 6 months)
Men dose 1
Vaccinations needed at 16 years
Men dose 2
Term for turbulent flow through an abnormal valve, vessel, or chamber.
heart murmur
can be innocent or pathologic
What is the Levine grading scale
Used to grade systolic murmurs (1-5)
1= soft murmur
5= loud murmur + thrill
Congenital heart defect where there is increased pulmonary blood flow d/t blood flowing from aorta to main pulmonary artery (low pressure); left heart dilation.
Patent Ductus Arteriosus
What are assessment findings of patent ductus arteriosus
systolic murmur
increased WOB
difficulty feeding
rales/congestion
What are nursing interventions for patent ductus arteriosus
diuretics, NSAIDs to promote closure, increased calories, possible surgical closure
Congenital heart defect where a portion of the atrial septal tissue does not completely form; increased pulmonary blood flow
Atrial septal defect
What are assessment findings for atrial septal defect
NO MURMURS
fixed split S2 sound
pulmonary overcirculation (rales, congestion, fatigued)
no HF s/s
poor weight gain
What are nursing interventions for atrial septal defect
small= monitor/ use diuretics to promote closure
large= closed via catheterization
Congenital heart defect where a portion of the ventricular septum does not completely close; increased pulmonary blood flow
Ventricular septal defect
What is the most common heart defect in children
ventricular septal defect
What are assessment findings of ventricular septal defect
murmur @ low sternal border
HF s/s= tachycardia, tachypnea, poor feeding, failure to thrive, rales
Congenital heart defect where there are lesions requiring intervention in the first year of life; decreased pulmonary blood flow
Tetralogy of fallot
What are the assessment findings of tetralogy of fallot
systolic murmur
hypercyanotic spells= cyanotic, distressed, irritable
What are the interventions for tetralogy of fallot
management of hypercyanotic spells
surgically repaired at 3-6 months
Congenital heart defect where there is narrowing of the aorta
Coarctation of the aorta
What are assessment findings for coarctation of the aorta
possible murmur
unequal pulses between upper/lower extremities
differed BP between upper/lower extremities
What gender is more at risk for coarctation of the aorta
males
Acquired heart disease of mucocutaneous lymph node syndrome; associated with
generalized vasculitis
Kawasaki’s disease
What is possible risk for a child with Kawasaki’s disease
thrombus formation, MI
What symptoms must be seen to diagnose Kawasaki’s disease
- changes in hands/feet (ex. peeling or edema)
- polymorphous exanthema- rash of trunk & extremities
- bilateral conjunctivitis
- cervical lymphadenopathy
How is Kawasaki’s disease diagnosed
diagnosed by exclusion (no labs/tests)
prolonged fever 5+ days
What are the risk factors for developing Kawasaki’s disease?
unknown/ possible genetic predisposition or infection
Mostly in winter and spring
More common in males
< 5 years old
Asian or Pacific Island descent
What are nursing interventions for Kawasaki’s disease
fever management
IVIG and aspirin therapy
Acquired heart disease d/t an autoimmune disease that occurs as a reaction to a group A beta-hemolytic streptococcal infection
Rheumatic fever
What is the pathophysiology of rheumatic fever
Inflammation from the immune response leads to inflammatory lesions in the heart, blood vessels, brain, and joints.
What are assessment findings of rheumatic fever
polyarthritis
carditis
Sydenham chorea= random involuntary limb movement
nodules on hard bony parts of joints
Erythema marginatum= rash on trunk
Elevated ASO titer (strep infection)
Nursing management for rheumatic fever
penicillin therapy
What are some assessment findings for a possible hematologic disorder
symptoms like pallor, lethargy, bruising
perform a bone marrow aspiration @ iliac crest or spine
Who is at risk for iron deficient anemia
breastfeeding infant/excessively consuming milk (9m-3yrs)
menstruating females
vegetarian
obese
What are assessment findings for iron deficient anemia
pale mucous membranes and skin
systolic murmur
decreased muscle tone
chronic fatigue
Hg <11g and Hct <33%
A recessive inherited disorder where RBCS are crescent-shaped and
hypoxic; leads to pain, ischemic tissue, cell destruction
sickle cell anemia
What are assessment findings for sickle cell anemia
will see signs @ 6 mos
Hg= 6-8g
thinly built
splenomegaly/hepatomegaly (abdomen protrudes)
icteric sclera
priapism= constant painful erection
Who is at risk for sickle cell anemia
Black people carry gene
GI or respiratory illness
Condition where there is a decrease in circulating platelets, usually 2 weeks after a viral illness/URI
Idiopathic thrombocytopenic purpura
What are the assessment findings for Idiopathic thrombocytopenic purpura
Abrupt onset
Miniature petechiae or large areas of
asymmetric ecchymosis usually over the legs
Thrombocytopenia
Bleeding, joint pain, epistaxis (nose bleed)
What are risk factors for Idiopathic thrombocytopenic purpura
recent viral illness
unvaccinated
congenital ITP (mom has it)
Term for inherited disorders of blood coagulation
hemophilia
What are assessment findings for hemophilia
excessive bleeding, easily bruises, prolonged PTT
What is a nursing intervention for hemophilia regarding the bleeding
administer factor VIII (coagulation agent to help treat bleeding)
Most frequently occurring type of childhood cancer characterized by distorted and uncontrolled proliferation of leukocyte
acute lymphatic leukemia
Assessment findings for acute lymphatic leukemia
Anemia
Easily bruise/bleed
Swollen lymph nodes
Joint pain, ab pain, fever
elevated leukocytes
Low platelets, HCT and RBCs
What population is more at risk for acute lymphatic leukemia
males
Hispanic and white
What are characteristics of a pediatric heart murmur that would indicate a pathologic cause
systolic or diastolic
longer in duration
harsh blowing sound
soft or loud
doesn’t change with position
