exam 2 Flashcards
Absolute neutrophil count (less than ____ the child is at risk for infection)
500
side effect of keto diet
kidney stones
Common causes- excessive PO intake, hypotonic fluid overload, kidney disease, CHF, malnutrition
Fluid Volume Excess:
The most common form of leukemia is _____
next is ____________
acute lymphoblastic leukemia (ALL)
acute myeloblastic leukemia (AML)
fracture where
- bone fragments into many pieces
Comminuted
Rare in children
Often due to Graves Disease
Increased basal metabolic rate-affecting cardiovascular, GI and neuromuscular function
Hyperthyroid
Clinical manifestations- edema, weight gain, bounding slow pulse, lethargic, increased spinal fluid pressure
Fluid Volume Excess:
Tonic clonic, mixed seizures
Side Effects: Hepatitis, agranulocytosis
Carbamazepine
Labs- low specific gravity, decreased hematocrit
Fluid Volume Excess:
Briefs contracture of muscle or group of muscles, alcohol and sleep deprivation can exacerbate, more common in teenagers, no loss of consciousness, no post ictal confusion
Myoclonic seizures
Results from imperfect closure or weakness of the umbilical muscle ring
Common condition more frequently noted in Black children and low birth weight infants.
Most resolve by 1 year
Potential for strangulation of bowel exists and should be monitored by Pediatrician
Umbilical Hernia
Seizures that last no more than 30 seconds, no post seizure confusion, can occur many times a day, no aura
eye and head turning in oppisite directions
simple partial seizure
level of dehydration where:
Weight Loss:6-10% Vital Signs Changes: slightly increased HR, normal BP Mucus Membranes:dry Tears: decreased Anterior Fontanel: normal to sunken Skin: cap refil 2-4 seconds Urine:oliguria
moderate
for dignostic criteria of diabetes
Plasma glucose concentration greater than or equal to ___ at any time of day regardless of time of last meal
200
Inflammation of the meninges, can be viral or bacterial – bacterial can be deadly
Meningitis
Antibiotics Droplet precautions Measure head circumference HOB above 30 degrees Monitor for increased ICP Seizure precautions Darken room
are all nursing interventions for
Meningitis
fracture where
bone breaks incompletly
greenstick
Common causes- SIADH, vomiting, diarrhea, increase insensible losses, diuretics, phototherapy, warmer
Fluid Volume Deficit:
Myelomeningocele region where
Paralysis of legs, sensory loss in trunk, weakness in trunk,
L2
Adrenocortical hyper-function resulting in excess blood levels of glucocorticoids (especially cortisol)
Excessive weight gain, growth retardation, hypertension, behavior problems, moonface, double chin
Cushing’s Disease
Head of the femur and acetabulum are not aligned
Affects mostly girls
Usually unilateral
dysplasia of the hip
fracture where
broken ends of bone are forced into each other
Impacted-
Idiopathic
Joint swelling (large joints like knee)
Stiffness
Multiple joints affected for 6 weeks or longer and have excluded other diagnosis’s
should be active as much as possible
outpatient treatment
Juvenile Arthritis
fever pallor lethargic anorexic large joint and bone pain petechie frank bleeding enlargement of liver and spleen lymphadonopathy
are comon clinical manifestations
Leukemia
fracture where
bone is crushed
Compression-
Viral inflammation of the liver
highly contagious fecal oral route and you can be immunized against this disease
Hepatitis A:
Asymmetry in trunk Uneven shoulders Curve in spine Uneven hips Protruding ribcage
clinical manifestation
Scoliosis
Replacement therapy (Synthroid or Levothyroxine) for life Newborn metabolic screen
treatment for
Hypothyroid
2 drugs Most often used for status epilepticus now
Side Effects: drowsiness, nystagmus, ataxia, paradoxical excitement
Monitor for respiratory depression, bradycardia, hypotension
Anticonvulsive for status epilepticus
Benzodiazepines:
Phenobarbital:
3 Hormones that enhance blood cell production and counteract the myelosuppressive effects of chemotherapy
Epoetin alfa
Filgrastim (nupogen) or Pegfilgrastim (neulasta)
Oprelvekin (Neumega) increases platelet count
can seizures be inturrupted by stimulation
no
Use for short term only
Infuse at no more than 150mg/min
Fosphenytoin sodium
Scoliosis
Between 10-40 degrees can be treated with ________
over 40 degrees is treated with _______
Boston brace
surgery (harrington rods)
Decreased appetite Dry cool skin Thinning hair Depressed deep tendon reflexes Bradycardia Constipation Sensitivity to cool temperatures Abnormal menses Goiter
specific to PEDs patients:
changes in past normal growth pattern with a weight increase
Muscle hypertrophy Muscle weakness Decreased height velocity Delayed bone and dental age Delayed or precocious puberty
Hypothyroid
Meningitis test where
raise leg with knee flexed – resistance or pain = positive
Kernig
Maintenance Fluid Requirement Calculation
0-10 kg (1st 10 kg) + 11-20 kg (2nd 10 kg + 20+ kg
100 ml/kg + 50 ml/kg + 20 ml/kg
Autoimmune process destroying the adrenal gland, results in deficiency of gluco- and mineralocorticoids
Weakness, fever, abdominal pain, hypoglycemia, seizures, hypotension, dehydration, shock and coma
Addison Disease
Used for partial and generalized seizures
Side Effects: metabolic acidosis, kidney stones, cognitive dysfunction, weight loss
Topiramate
For dysplasia of the hip
For infants the_______ is the most common treatment method for hip reduction
pavlik harness
A renal disorder in which the basement membrane of the glomeruli becomes permeable to plasma proteins.
Nephrotic Syndrome
Asymmetrical gluteal Folds of skin on the inner thigh
One leg may be shorter than the other
Barlow test
Ortolani test
Older than one year old Walk with a limp or have waddling gait, Trendelenburg test (hip drop while standing on one leg)
are clinical manifestations of
dysplasia of the hip
Performed at 24-48 hours of life to detect disorders in newborns shortly after birth
These conditions can cause significant and life long complications if left untreated
Newborn Metabolic Screen
Septic shock
Hypercalcemia if a large amount of bone is destroyed
Thrombocytopenia – decreased platelets that can lead to DIC
Pressure on brain or spinal cord from tumor growth
Tumor lysis syndrome
are all considered _____
Oncological Emergencies
is a chronic inflammatory process that can occur throughout the GI tract.
Inflammation can involve the mucosa to the bowel wall.
Crohn’s Disease
Therapeutic level 10-20mcg/ml
Monitor drug interactions Ensure oral hygiene Monitor CBC Report any rash IV admin flush well before and after admin Do not admin with milk
Phenytoin:
one therapy for infants with Hydrocephalus
VP shunt
______ or______ are the most commonly occurring solid tumors in children and second to only leukemia for malignancies
CNS or brain tumors
Pain Cachexia Anemia Infection Bruising Neurological symptoms Palpable mass or masses Can be an incidental finding
are clinical manifestations of ______
cancer
polyuria, polydipsia,polyphagia with weight loss Glycosuria Hyperglycemia Fatigue Vaginitis Lethargy Headache Stomachache
are all clinical manifestaions of
type 1 diabetes
Slippage of growth plate
Usually during growth spurt, overweight children, trauma
Can be chronic or acute (less than 3 weeks)
surgial repair is needed
Slipped capital femoral epiphyses ( SCFE)
normal blood sugar rang
60-120
Clubfoot: Talipes Equinovarus
methods for correction
Cereal casting – casting for a week and then resize and casting agin
surgical step at 3-12 months old
level of dehydration where:
Weight Loss: <5% Vital Signs Changes:no changes Mucus Membranes: normal Tears: present Anterior Fontanel: normal Skin:cap refil <2 seconds Urine: decreased
mild
may be asympotomatic
abd distention
hematuria
abd pain
are clinical manifestations of
Wilms Tumor
apnea spells, failure to thrive, cat like cry, difficulty feeding, sun setting eyes,
late signs in infants of Hydrocephalus
Retrograde flow of urine from the bladder into the ureters
Incomplete emptying of the bladder, creating a reservoir for bacterial growth
Vesicourethral Reflux (VUR
Medication
Diet
Surgery
Vagal nerve stimulator
are all tratment options for
seizure disorder
growth plate is open until ____ years old
20
is an upper UTI that involves the ureters, renal pelvis and renal parencyma
Pyelonephritis
Absence seizures
Myoclonic seizures
Side Effects: drowsiness, hyperactivity, agitation, increased salivation
Clonazepam
regulated by thirst
Role is to bind to the collecting ducts of the kidneys to promote reabsorption of water back into circulation
Antidiuretic Hormone
Stage of development & Response to death for which age group
Start to respond to logic and facts
Older school-age children have a better concept of the permanence of death
Fear
Curiosity
schoolage
Myelomeningocele region where
weaker absent ankle extension
L4-5
Often associated with anomalies of the musculoskeletal system. Associated with VACTERL syndrome
Depending on the level of deformity will determine how much surgery and bowel control will be possible
Anorectal Malformations
2nd degree burn is called
partial thickness
This is a clinical and surgical emergency! Characterized by Coughing Choking and Cyanosis
Esophageal Atresia (EA)
Tracheoesophageal Fistula
Can be caused by CNS disturbance, trauma
Clinical manifestation – polyuria, thirst, hypernatremia, dilute urine, dehydration
Can cause seizures if not caught early
Diabetes Insipidus (DI)
Stop process
Airway, breathing, circulation
IV access for fluid and immediate pain relief
are important interventions for
burns
Can see in children as young as 8
Risk factors: sedentary lifestyle, high fat diet, race, family history
Signs and symptoms slow to develop
Insulin resistance or decreased insulin receptors
type 2 diabetes
Older children : fever, confusion, delirium, decreased LOC, vomiting, headache, neck pain, nuchal rigidity, photophobia, petechiae
are al signs of
Meningitis
Force exerted by brain tissue, cerebrospinal fluid and blood within the cranial vault
ICP:
4 things that can lead to ICP
tumor
meningiis
bleeding
injury
Solid tumor most commonly occurring outside the cranium of children.
Commonly a smooth, hard, non-tender mass that can occur anywhere along the sympathetic nervous system chain
most frequently with the adrenal glands in abdomen
Neuroblastoma
Clinical manifestations- Thirst, variable temp, weight loss, decreased urine output (weigh diaper), irritable, lethargic, tachycardia, tachypnea
Fluid Volume Deficit:
Stage of development & Response to death for which age group
Egocentric Magical thinking Control and responsibility Punishment Death is temporary
preschool
Catheterization Bowel program Skin assessment ROM Consistency of care Support independence and realistic expectations
are all long term care for
Myelomeningocele (Spina Bifida)
fracture where
broken ends of bone protrude through soft tissues and skin
Open-
Congenital abnormality – foot is twisted out of position
More common in boys , family history, unilateral or bilateral
Muscles, tendons and bones are involved
Clubfoot: Talipes Equinovarus
Water reabsorbs back into circulation, regardless of serum osmolality resulting in ________
Syndrome of Inappropriate Diuretic Hormone (SIADH)
bulging fontanel, wide sutures, increased head circumference, dilated scalp veins, irritability, cat like cry (high pitched)
are all _____
early signs of ICP in infants
No brain above the brain stem, incompatible with life
Anacephaly
accoring to Monro-Kellie hypothesis what 3 things make up normal ICP
blood
CSF
brain tissue
Third most common cancer in children following leukemia and brain tumors
7- 11 years
3 times more comon in boys
Non-Hodgkin Lymphoma
Spontaneous genetic mutation, autosomal recessive transmission of enzyme deficiency, hypoplasia or aplasia of thyroid
Must be identified early to prevent permanent cognitive impairment
Idiopathic or autoimmune thyroiditis (Hashimoto’s)
Hypothyroid
fracture where
bone breaks but does not penetrate the skin
Closed –
normal ICP levels are
emergency treatment is needed if it reaches ___-
7-15
20
Autoimmune destruction of insulin producing pancreatic islet beta cells
Occurs in 1 in every 400-600 children and adolescents
peak diagnosis 4-6 years old
Insulin insufficiency
type 1 diabetes
chemo
consolidation or induction
maintenace chemo
are the
3 phases of treatment for
Leukemia
are periods of abnormal electrical discharges in the brain that cause involuntary movement and behavior and sensory alterations.
Seizures
Monitor liver function on therapy
Therapeutic levels 6 -12 mcg/ml
Carbamazepine
Breakdown of tumor cells that releases high levels of uric acid, potassium, and phosphates into the blood causing hyper states of all, hypocalcemia and additionally a lower sodium level leading to metabolic acidosis, cardiac arrhythmias and/or renal failure,
Tumor Lysis Syndrome (TLS)
Partial seizures, tonic clonic and absence seizures
Side effects: dizziness, headache, nausea, rash
Lamotrigine
Herniation leads to _____
ireversible brain death
test for Last 60 -90 days average blood sugar history
normal is _____
Hgb AIC
4-6 (60-120)
Brittle bone disease
Autosomal dominant or Mutation in the gene that affects bone formation
type 2 is the most severe
8 different types
type 1 most commmon and least severe
Osteogenesis Imperfecta - OI
Young infants: fever, hypothermia (newborn), change in feeding, vomiting, diarrhea, irritable, restless, lethargic, more irritable during rocking,
are all signs of
Meningitis
Narrowing of the pyloric canal. The sphincter, or circular muscle of the pylorus, hypertrophies to over twice the normal size
Most often occurs in first-born males
Position on right side with hob up
Pyloric Stenosis
Diagnosis based on 2 behavioral domains:
Difficulties in social communication and interaction
Unusually restricted, repetitive behaviors and interests
Autism Spectrum Disorder
fracture where
broken bone is pressed inward
depressed
fontanels close at
18 months
Therapeutic levels 20-80mcg/ml
Do not abruptly discontinue
Monitor liver function, CBC and renal function periodically
Clonazepam
Immunologic disorder characterized by intolerance for gluten a protein found in wheat, barley, rye and oats.
The inability to digest glutenin and gliadin results in accumulation of the amino acid glutamine that is toxic to mucosal cells of the intestines.
Celiac Disease
Etiology: excessive secretion of growth hormone, can be a tumor of the hypothalamus if associated with precocious puberty
Clinical Manifestations-dependent on timing of hypersecretion
Growth Hormone excess
Absence seizures
Myoclonic seizures
Side Effects: hepatotoxic, prolonged bleeding times, GI disturbances
Valproic acid
A nephroblastoma is an intrarenal tumor that most often is a Wilms Tumor that is a common abdominal tumor in children
should not use deep palpation technique with these patients
Wilms Tumor
Viral inflammation of the liver
: occurs only in those who have had Hep B
Hepatitis D
type of dehydration that
Loss of salt > water
Water transfers from ECF to ICF to establish equilibrium, resulting in greater ECF volume loss
Physical signs tend to be more severe with smaller amount of fluid loss
Na+ <130
Hypotonic
Most common bacteria is ________ Meningitidis.
Neisseria
Meningeal sac contains CSF and a portion of the spinal cord
Myelomeningocele
Myelomeningocele region where
mild weakness in ankles and toes
sacral
Injury that is not consistent with the story
Lacerated external genitalia
Torn, stained or bloody underwear
Bedwetting
Frightened or withdrawn in presence of an adult
Delayed care
are all signs of
child abuse
is a lower UTI that is in the urethra or bladder
Cystitis
Monitor liver function
Potentiates phenobarbital and Dilantin altering blood levels
Therapeutic levels 50-100mEg/ml
Valproic acid
Infection in the bones
Most common in lower extremity
Boys most common between age 1-12
Can happen from trauma to bone
PICC line antibiotics for 3-6 weeks
Osteomyelitis
Lumbar Puncture for Meningitis will show what 4 things
Increased white count
Decreased glucose
Elevated protein
Positive culture for bacteria
Imbalance in reduction and absorption in the CSF
Hydrocephalus
Scoliosis or kyphosis, incontinent of urine and feces, constipation, sensory loss around genitalia, hip dysplasia, clubbed foot, difficulty swallowing, inspitroy stridor, poor cry, backward arching of head
are signs of
Myelomeningocele (Spina Bifida)
4 common diagnostic tests for cancer are
Bone Marrow Aspiration
Lumbar puncture
Complete blood count and differential
Absolute neutrophil count (less than 500 the child is at risk for infection)
for dysplasia of the hip
In children over __ months the treatment is open or closed reduction of the hip followed by hip spica casting and bracing depending on age.
6 months
Hydrocephalus 3 nursing precautions
Seizure precautions
Monitor for ICP
Pre and post-op care
Infection Seizures activity Sensorimotor defects Hydrocephalus Growth problems Endocrine problems Impaired cognitive function Behavioral changes
are common problems with
Brain Tumors
Vigorous hydration with 2-3 times maintenance fluids
Correction of electrolyte imbalances
Administration of allopurinol or urate oxidase to reduce conversion of metabolic by-products to uric acid
EKG monitoring for arrhythmias
Lasix administration to promote excretion of potassium
Dialysis may be required if severe
are treatments for
Tumor Lysis Syndrome (TLS)
what is the diagnostic test for Meningitis
Lumbar Puncture
Congenital anomaly occurring when the esophagus does not fully develop
Most commonly the upper esophagus ends in a blind pouch with the lower part of the esophagus connected to the trachea
Esophageal Atresia (EA)
Tracheoesophageal Fistula
altered bowel and bladder function weight loss abd distention enlarged liver irritable fever difficulty breathing infection facial edema
are signs and symptoms of
Neuroblastoma
when should you give a child insulin
after meal because they are unpredictable eaters
increased ICP, headache when arising, nausea and vomiting, fussy, sleepy, altered LOC, poor appetite, visual problems, change in personality
are signs of
Hydrocephalus in children
Triggered by hyperventilation or flashing lights, brief loss of consciousness, no more than 30 seconds, no post seizure confusion, amnesia during this time, can have 50 to 100 per day, cant be inturrupted with stimulation
Absence seizures
level of dehydration where:
Weight Loss:10%+ Vital Signs Changes: tachycardia, orthostatic BP Mucus Membranes:parched Tears:absent Anterior Fontanel:sunken Skin: cap refil 4+ seconds Urine:anuria
severe
if ICP gets too high we are concerned about ______
Herniation
Stage of development & Response to death for which age group
Little to no concept of death
Egocentric
Mirror parental emotions
Regression to an earlier stage of behavior
infants/ todders
Consciousness is impaired, automatism, may progress to generalized seizure, aura present, last 30 seconds – 5 mins, post ictal confusion
Complex partial seizures
Protrusion of the meningeal sac that is filled with just CSF, no spinal cord defect
Meningocele
Labs – specific gravity high in urine, increased hematocrit, increased BUN
Fluid Volume Deficit:
Monitor for metabolic acidosis
Increase fluid intake to reduce risk of kidney stones
Psychomotor slowing as well as speech and language problems may develop with use of medication
Topiramate
fracture where
jagged break due to twisting force applied to bone
spiral
Developmentally inappropriate degrees of inattention, impulsiveness and hyperactivity
Attention Deficit Hyperactivity Disorder (ADHD)
A malignant, small, round cell tumor on diaphyseal or shaft portion of bones
translocation of chromosomes
Ewing Sarcoma
Etiology: decrease activity in pituitary gland as a result of infarction or restriction
clinical manifestations: lack of growth
Growth Hormone deficit
30-40% New onset Type 1 DM present with DKA
Can be life threatening
Weight loss, abdominal pain, nausea, vomiting, tachycardia, dehydration, flushed ears and cheek, acetone breath, kusmal respiration, altered level of consciousness, hypotension, hypoglycemia, ketones in the urine
cerebral edema can cause death
Diabetic Ketoacidosis
Tonic clonic and partial seizures treatment
Side Effects: gingival hyperplasia, dermatitis, ataxia, nausea, anorexia, bone marrow depression, nystagmus
Phenytoin:
type of dehydration that
Primary form of dehydration in children
Equal loss of water and salt
Decreased circulating volume leads to shock
Isotonic
Lethargic, vomiting, resp irregular, coma
are common signs of _____
Shaken Baby Syndrome
Most commonly diagnosed pediatric malignancy in children under 14 years of age
Proliferation of abnormal white blood cells in body
Leukemia
what area of the brain does a generalized seizure affect
all
Congenital malformation of the anorectal area – most often imperforate anus (no anal opening) and often with a fistula present
Can be associated with malformation of the urinary tract and the reproductive system
Anorectal Malformations
for dignostic criteria of diabetes
Fasting plasma glucose greater than ____ (no caloric intake for 8 hours)
126
Fever Pain Local inflammation Joint tenderness Swelling Loss of movement
clinical manifestations of ______
Septic arthritis
Antibody complexes become trapped in glomeruli membrane, causing inflammation and decreasing glomerular filtration
Acute Glomerulonephritis (AGN)
Withhold drug if rash develops
Do not discontinue abruptly
Lamotrigine
5 things on Newborn Metabolic Screen
Congenital adrenal hyperplasia, hypothyroid Cystic Fibrosis Sickle Cell Disease Severe Combined Immune Deficiency (SCID) Phenylketonuria (PKU) A variety of other metabolic disorders
decreased Urine Output decreased Serum Sodium decreased Serum Osmolality increased Urine Sodium increased Specific Gravity
SIADH
Viral inflammation of the liver
is blood or body fluid transmission – immunizations have reduced the occurrence of this disease
Hepatitis B
Stage of development & Response to death for which age group
Adult-like concept of death
Difficulty accepting death
Peers
Guilt & Shame
adolescent
ADH is not regulated, therefore tubules do not reabsorb water resulting in _______
Diabetes Insipidus (DI)
every case of Myelomeningocele (Spina Bifida) will have
bladder and bowel dysfunction
3rd degree burn is called
full thickness
Bone pain Edema Decreased mobility Fever Redness
are clinical manifestations of
Osteomyelitis
Myelomeningocele region where
paralysis of ankles and toes
L3
can be caused by CNS disturbance, medications, pulmonary disturbances
Clinical manifestations – JVD, high bp, crackles, pulmonary congestion, weight gain with no edema, changes in LOC,
Could result in death from cerebral edema
Syndrome of Inappropriate Diuretic Hormone (SIADH)
Can develop rapidly in Type 1 DM
Children at high risk due to growth rates, unpredictable eating habits and physical activity
Severe episodes can occur at night
Need to identify cause
Treatment-dependent on LOC
Hypoglycemia
This occurs when a parent fabricates or causes symptoms in a child that results in the child being subjected to multiple invasive tests and treatments
The parents then get a great deal of attention from the health care team and are usually viewed as a very caring and attentive parent!
Munchausen Syndrome by Proxy
inherited
Muscle wasting
X linked (only seen in boys)
Terminal disorder
by the time in preteens can no longer walk
life expectancy into mid 20’s
prednisone therapy
Muscular Dystrophy
is a chronic recurrent disease, primarily of the large intestine and rectal mucosa .
Inflammation is limited to the mucosa.
Ulcerative Colitis
type of dehydration that
Loss of water > salt
Proportionally larger loss of water or larger intake of electrolytes
Fluid shifts from ICF to ECF to establish equilibrium
Most dangerous, requires most specific therapy
Na+ >150
Hypertonic
Autosomal recessive disorder
The body cannot metabolize the essential acid phenylalanine
Lighter pigmentation, musty odor. Widely spaced teeth, growth retardation
If not managed can cause mental retardation
Phenylketonuria (PKU)
Viral inflammation of the liver
transmitted through blood and blood products and chronic infection occurs in over 50%
No immunization is available at this time
Hepatitis C:
clinical manifestation
Multiple bone fractures Weak muscles Blue or gray sclera Larger cranium Short stature
Osteogenesis Imperfecta - OI
with cancer patients
Frequent urinalysis for assessment of specific gravity less than ______
Urine PH should be _____
1.010
7-7.5
Most common tumor affecting the skeleton of children
puberity growth sputs (most commmon)
Osteosarcoma
Protrusion of the meningeal tissue
Encephalocele
1st degree burn is called
superficial
Significant decrease in LOC Seizures Cushing triad Fixed and dilated pupils, papilledema Increased systolic blood pressure Bradycardia Irregular respirations posturing
are all _____
late signs of ICP
manuever for Muscular Dystrophy for lying down to stand up where they walk up the body
Gowers maneuver
pain
swelling of limb
limp if on leg
are clinical manifestations of
Osteosarcoma
Complex neurodevelopmental disorders of unknown etiology
Autism Spectrum Disorder
Anticonvulsive for status epilepticus, prevention of seizures during neurosurgery
Side Effects: rapid infusion lead to hypotension. Has severe SE
Fosphenytoin sodium
Seizures Apnea Cerebral edema Increased ICP Subdural effusion Hydrocephalus Disseminated intravascular coagulation Shock
are all
Late ominous signs of Meningitis
Increased Urine Output increased Serum Sodium increased Serum Osmolality decreased Urine Sodium decreased Specific Gravity decreased Urine Osmolarity
DIABETES INSIPIDUS
are childrens bones more or less dense than adults
more dense
Head circumference increased rapidly, widen split sutures, frontal area not proportionate to skull size, difficulty holding head up, translucent skull veins, hyper reflexes, brisk deep tendon reflexes, poor feeding, decline in LOC
are alll ____
early signs in infants of Hydrocephalus
Vertebral defect, don’t fuse,
Spina bifida occulta
Lateral S or C shape of the spine
Anything more than 10 degrees will get diagnosis
most comon in girls (age 10-13)
idiopathic
Scoliosis
for dignostic criteria of diabetes
Two hour plasma glucose greater than or equal to ____ during an oral glucose tolerance test
200
At times a child may be put in _________ if splinting is ineffective prior to surgery or spica casting
Must maintain hips in 90 degree flexion with buttocks off bed
Bryant traction
Does not have good innervation to the colon and you end up with a mega colon because of no peristalsis
Alternating constipation and diarrhea
No meconium stool in the first 24 hours
Nutritionally deficient
Hirschprung Disease
Meningitis test where
Lying supine- flex head, involuntary knees and hips flexing – positive sign
Brudzinski
medical emergency
Infection of the synovial space
Most common in knee but can see in ankles, elbow and hips
Septic arthritis
after 5 mins of a seizure ____or_____ is usually given
valium or phenobarbital
Acute encephalopathy
Permanent tissue damage, liver disfunction, associated with using aspirin
Cerebral edema, hypoglycemia, enlarged poorly function liver, seizure, change in LOC
supportive care
Mannitol
Reye Syndrome
