exam 2 Flashcards by britt rank

Absolute neutrophil count (less than ____ the child is at risk for infection)

500

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side effect of keto diet

kidney stones

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Common causes- excessive PO intake, hypotonic fluid overload, kidney disease, CHF, malnutrition

Fluid Volume Excess:

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The most common form of leukemia is _____

next is ____________

acute lymphoblastic leukemia (ALL)

acute myeloblastic leukemia (AML)

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fracture where

- bone fragments into many pieces

Comminuted

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Rare in children

Often due to Graves Disease

Increased basal metabolic rate-affecting cardiovascular, GI and neuromuscular function

Hyperthyroid

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Clinical manifestations- edema, weight gain, bounding slow pulse, lethargic, increased spinal fluid pressure

Fluid Volume Excess:

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Tonic clonic, mixed seizures

Side Effects: Hepatitis, agranulocytosis

Carbamazepine

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Labs- low specific gravity, decreased hematocrit

Fluid Volume Excess:

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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

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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

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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

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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

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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

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Inflammation of the meninges, can be viral or bacterial – bacterial can be deadly

Meningitis

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Antibiotics 
Droplet precautions 
Measure head circumference 
HOB above 30 degrees 
Monitor for increased ICP
Seizure precautions 
Darken room

are all nursing interventions for

Meningitis

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fracture where

bone breaks incompletly

greenstick

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Common causes- SIADH, vomiting, diarrhea, increase insensible losses, diuretics, phototherapy, warmer

Fluid Volume Deficit:

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Myelomeningocele region where

Paralysis of legs, sensory loss in trunk, weakness in trunk,

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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

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Head of the femur and acetabulum are not aligned

Affects mostly girls

Usually unilateral

dysplasia of the hip

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fracture where

broken ends of bone are forced into each other

Impacted-

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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

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fever 
pallor
lethargic 
anorexic 
large joint and bone pain
petechie 
frank bleeding 
enlargement of liver and spleen 
lymphadonopathy

are comon clinical manifestations

Leukemia

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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

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

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

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