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Mom, baby and pediatrics > Exam 3 Review > Flashcards

Exam 3 Review Flashcards

1
Q

As a nurse, what do you have to teach parents that have children with GER?

A

Administer protonics 30 minutes prior to feedings only one times a day.

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2
Q

What are the signs and symptoms for Hirshsprungs Disease in infants?

A 
Failure to thrive.
Ominous sign- explosive diarrhea, fever, enterocolitis.
Constipation
Abdominal distention.
Diarrhea and vomiting.
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3
Q

When does the anterior fontanel close?

A

9-18 months

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4
Q

What is the main thing that adolescents or teenagers want during hospitalization?

A

They want their peers with there. They will be eager to have their peers come visit them.

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5
Q

Describe the pathophysiology of PKU.

A

The inability to produce an enzyme to break down essential amino acid (phenylalanine)

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6
Q

What is acute lymphoid leukemia (ALL)?

A

An unrestricted proliferation of immaute WBCs in the blood-forming tissues of the body

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7
Q

When do the signs and symptoms of GER occur?

A

Throughout the day but most frequently after meals and at night.

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8
Q

What is cellulitis?

A

A bacterial infection in a specific area or region of the body.

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9
Q

How are hyperthyroidism babies characterized?

A

As good babies that sleep all the time.

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10
Q

T/F: All children, even those with chronic or acute serious illnesses, need limits and discipline.

A

True.

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11
Q

What age can an infant roll over?

A

4 months

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12
Q

If baby is less than a year, what do you use for food when weaning off breast milk?

A

Iron fortified formula.

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13
Q

What is the cause of PKU?

A

It is an autosomal recessive disease,

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14
Q

What is tracheoesophageal fistula (TEF)?

A

The failure of esophagus to develop as a continuous passage.

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15
Q

What are the signs and symptoms of intussusception?

A

Severe colicky abdominal pain in a child with vomiting and currant jelly-like stools. Stools may be mucousy red like stools.

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16
Q

What are the signs and symptoms for Hirshsprungs Disease in childhood age children.

A

Constipation, ribbon like, foul-smelling stools, abdominal distention, visible peristalsis, fecal mass easily palpable, anemia, poor nourished.

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17
Q

What is the treatment for Type I diabetes?

A

Insulin SubQ
Regular insulin through IV
Insulin pump if child is older than 2 years old.

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18
Q

What are the initial signs and symptoms of Hirshsprungs Disease?

A

Usually severe and continuous constipation.

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19
Q

Is there a vaccine for the Rotovirus?

A

yes but it must be given in the first 3 months (it is a 3 series vaccine).

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20
Q

What is the treatment for newborns with PKU?

A

They are placed on a formula with a very low level of phenylalanine or continue on breast milk which is already low in penylalanine.

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21
Q

What is the treatment for pyloric stenosis?

A

A surgical procedure.

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22
Q

What are the signs and symptoms of pyloric stenosis (three p’s)

A

Projectile vomiting
Palpable olive-like mass
Visible peristaltic waves

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23
Q

What age does an infant double their birth weight?

A

6 months

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24
Q

Why is toddler in need of small frequent meals?

A

Because they are busy exploring and they will not sit to eat a big meal.

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25
Q

Why are patients with pyloric stenosis prone to metabolic alkalosis?

A

Because they are throwing up and there is no bile in it.

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26
Q

What is important patient teaching regarding cellulitis?

A

It spreads easily so wash hands!!

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27
Q

How do you prepare school age children for hospitalization?

A

By giving them more information.

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28
Q

What happens in Type 2 diabetes?

A

Insulin resistance due to the body failing to use insulin properly combines with relative insulin deficiency.

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29
Q

How do you cleanse the suture site post op cleft lip repair?

A

With a cotton tipped swab in saline water and a thing layer of antibiotic ointment.

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30
Q

T/F: Cognitive deficits and developmental delays are not associated with hyperthyroidism.

A

False.

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31
Q

How is poison ivy treated?

A

Lather irritated area in shower two to three times

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32
Q

What is the proper positioning post op for a repaired cleft palate?

A

On the abdomen to reduce risk of aspiration.

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33
Q

What age does the industry stage occur?

A

6-12 years.

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34
Q

How do you treat impetigo?

A

Remove honey colored crusts
Apply topical antibiotic
Use antibacterial soap for 5-7 days

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35
Q

How is Rotovirus typically spread?

A

Fecal-Oral route

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36
Q

What is intussusception?

A

When one portion of the bowel slides into the next. Sort of like a telescope.

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37
Q

What is the goal of treatment for Hirshsprungs Disease?

A

To surgically remove the diseased, nonfunctioning segment of the bowel and restore bowel function.

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38
Q

How is the repaired cleft lip protected post op?

A

By a thin, arched metal device called logan bow

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39
Q

What is a favorite word used by toddlers in the autonomy stage and why?

A

No because they are becoming independent and this is there control over the world.

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40
Q

How is lice infected bedding cleaned and dried?

A

Wash in high temperature water and dry on high heat for at least 20 minutes

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41
Q

How do you treat lice?

A

By destroying the eggs with specialized shampoos and high temperature water when washing bedding.

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42
Q

What is sickle cell anemia?

A

Its an autosomal recessive diease. The normal hgb is replaced with abnormal hgb S

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43
Q

What are signs and symptoms of PKU?

A 
Musty smell from body
Seizures
Hyperactivity
Irritability
Vomiting
Eczema
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44
Q

How do you treat acne?

A 
Washing with soap and water
Adequate rest
Moderate exercising
A well-balanced diet
Wash hair more frequently
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45
Q

How does Type II diabetes form?

A

Immune-mediated diabetes mellitus. It is an autoimmune destruction of the beta cells.

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46
Q

Why are adolescents at risk for developing iron deficiency anemia?

A

Because of rapid growth and poor eating habits.

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47
Q

How many stages are there to the treatment for Hirshsprungs Disease?

A

Two stages.

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48
Q

In what order is a cleft lip/ palate repaired?

A

The lip is repaired first and then the palate is repaired second.

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49
Q

What are the signs and symptoms of iron deficiency anemia??

A

Pallor
Fatigue
Tachycardia
Cool skin

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50
Q

What is the treatment for Rotovirus?

A

Oral hydration to prevent dehydration, do NOT use BRAT diet.

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51
Q

What do parents need to be taught regarding elbow restraints?

A

Release the restraints one at a time and be sure to monitor skin for breakdown.

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52
Q

What food are important for infants?

A

Breast milk or iron fortified formula.

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53
Q

What medication is used to treat hypothyroidism?

A

Levothyroxine or synthroid.

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54
Q

What is scabies treated with and how long is the treatment?

A

A topical oinment that must stay on the skin for at least 8 hours.

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55
Q

What are the four characteristics of celiac disease?

A

Steatorrhea
General malnutrition
Abdominal distention
Secondary vitamin deficiencies.

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56
Q

How do you prevent hypoglycemia in children?

A

Give them adequate snacks.

Monitor blood glucose especially if they are going to be outside or exercise.

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57
Q

What leads to a sickle cell crisis?

A

When microscopic obstructions lead to an engorgement and tissue ischemia… Hypoxia occurs and causes sickling.

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58
Q

Describe the second stage of Hirshsprungs Disease.

A

When the child’s weight (20 lbs or 1 year old) or condition is deemed appropriate the surgeons close the stoma (reconnect the intestines) removed the diseased portion of bowel, and perform a pull-through procedure, which repairs the colon by connecting functional bowel to the anus. This usually establishes fairly normal bowel function.

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59
Q

What is the impact of PKU if it is not treated?

A

Profound cognitive deficits.

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60
Q

What is the treatment for sickle cell anemia?

A

Fluids
Oxygen
Pain medication

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61
Q

What is the first thing that you do when intussusception has reversed?

A

Notify the physician.

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62
Q

What are the CNS related signs and symptoms of acute lymphoid leukemia (ALL)?

A

Increased ICP
Headache
Vomiting
Papilledema and nerve palsy

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63
Q

What causes the skin irritation in poison ivy?

A

Burshin oil

64
Q

According to Erikson’s 5 developmental theory what are two toys that are appropriate for babies

A

Rattlers and mobiles

65
Q

How should food be served to toddler?

A

In small pieces.

66
Q

What are signs and symptoms of appendicitis?

A 
Periumbilical pain
Nausea
RLQ pain
Increased WBC
Later vomiting with a fever
67
Q

According to Erikson’s 5 developmental theory what kind of play is associated with preschool age children?

A

Associative play.

68
Q

How do you administer iron to older children?

A

Mix it in a cup with a straw.

69
Q

What type of food does a post op cleft palate discharged baby need to avoid?

A

Bread, hard cookies, chips.

70
Q

What are the different treatments for intussusception?

A

Radiologist guided pneumo-enema

Ultrasound guided saline enema

71
Q

What is impetigo?

A

Staph infection which usually occurs on face or legs.

72
Q

When do signs and symptoms begin to develop in infants with pyloric stenosis?

A

Between 2 and 5 weeks of life and typically 30 minutes after eating.

73
Q

What age does the identity stage occur?

A

12-18 years.

74
Q

What are the signs and symptoms of cellulitis?

A 
Rapid onsent
Ill
Erythema
Warmth
Tenderness
Chills
Septicemia and edema of infected site
75
Q

When does Type I diabetes typically occur?

A

In children or in slim adults.

76
Q

What are some signs and symptoms of hypothyroidism in children?

A

Large fontanelles
Protruding tongue
Temperature instability (temp will drop quickly)

77
Q

How long are babies typically in elbow restraints following cleft lip/pallet repair?

A

4-6 weeks.

78
Q

A small percentage of children who have lingering problems from Hirshsprungs Disease could be at risk for?

A

Soilage or constipation

An overgrowth of bacteria in the intestines.

79
Q

Can the mother breastfeed post op cleft lip repair?

A

Yes, may need a lactation specialist though.

80
Q

What is the treatment for cellulitis?

A

Warm compress

Antibiotics

81
Q

Describe the first stage of Hirshsprungs Disease.

A

The first stage relieves the intestinal obstruction by performing a colostomy, which creates an opening in the abdomen (stoma) through which bowel contents can be discharged into a waste bag.

82
Q

What are signs and symptoms of scabies?

A

Infected areas will turn red and will begin to itch.

83
Q

What are the nursing interventions for tracheoesophageal fistula (TEF)

A

Elevate the bed to 30 degrees to prevent aspiration.
Broad spectrum antibiotics to prevent pnemonia.
NPO immediately
Give passifier
Start IV fluids

84
Q

Describe associative play.

A

Initiative play or dramatic type play.

85
Q

What does Rotovirus cause?

A

Diarrhea

86
Q

By what age should a child have their first tooth?

A

By 1 year.

87
Q

T/F: Preschoolers enjoy playing with puppets and dress up and are into imitating parents.

A

True.

88
Q

Acute lymphoid leukemia (ALL): What is induction therapy?

A

Corticosteroids, Vincristine, L-Asparaginase

89
Q

How do you establish trust with infants?

A

By holding and feeding them if possible.

90
Q

How is GER treated?

A

Small frequent feedings.
Sitting upright for 1 hour after feedings.
Thickening the formula for infants.
Left sided positioning during sleep and elevating HOB for children older than 1 year.

91
Q

According to Erikson’s 5 developmental theory what are some toys that would be appropriate for preschoolers?

A

Tricycles, clay, paints, swings, sliding board

92
Q

What are scabies?

A

Lesions created as the impregnated female insect burrows into the outermost layer of the epidermis to deposit her eggs and feces.

93
Q

How do you help establish autonomy for a toddler in a hospital setting?

A

Help maintain rituals. You want to continue doing the same things they do at home.

94
Q

What are the signs and symptoms of tracheoesophageal fistula (TEF)?

A

Coughing
Choking
Cyanosis

95
Q

What is the treatment for hypoglycemia?

A

Juice or regular soda
Glucose tab or gel
Glucagon subQ

96
Q

Describe the restaints used for post op cleft lip repair.

A

Soft elbow restraints.

97
Q

What are some tests done to diagnose acute lymphoid leukemia (ALL)?

A

Bone marrow aspiration or biopsy.
Complete blood count
Lumbar puncture to evaluate CNS involvement.

98
Q

What must parents be taught about administering medication for hypothyroidism?

A

It can be crushed or given in a small amount of juice or liquid and can be given through a syringe.

99
Q

What are signs and symptoms of Type I diabetes?

A 
Polyuria
Polydipsia
Polyphagia
Weight loss
Tachycardia
Fatigue
100
Q

What is the treatment for Celiac disease?

A

Gluten free diet (low gluten diet)

Eliminate wheat, rye, barley and oats with corn and rice.

101
Q

What is iron deficiency anemia?

A

Anemia with reduced Hgb concentration.

102
Q

When are newborns screened for PKU?

A

After 2-3 or at least 24 hours on formula or breast milk.

103
Q

What is the proper positioning post op for a repaired cleft lip?

A

On their back, side or sitting up in a chair

104
Q

What causes acne?

A

Testosterone

105
Q

What are nursing care measures you can implement to help an ALL patient?

A

Use a private room
Screening and restriction of all visitors and health personal with active infection
Strict hand washing

106
Q

What is an important nursing intervention for iron deficiency anemia?

A

Decrease oxygen demands (keep patient on bed rest or low activity).

107
Q

What are the signs and symptoms for Hirshsprungs Disease in newborns?

A

Failure to thrive.
Failure to pass meconium stool within 24-48 hours after birth.
Reluctant to ingest fluids.
Abdominal distention.

108
Q

What complications can arise from acute lymphoid leukemia (ALL)?

A

Anemia from decreased RBCs
Infection from neutopenia
Bleeding tendencies from decreased platelet production

109
Q

Describe parallel play.

A

When one plays alongside another.

110
Q

Which two age groups are at high risk of developing iron deficiency anemia?

A

Infants and adolescents/ teens

111
Q

When are most children diagnosed with Hirshsprungs Disease?

A

Within the first few months of life.

112
Q

When does Type 2 diabetes typically occur?

A

In older adults.

113
Q

What do you look for in children with hypoglycemia?

A

Unusual behaviors.

114
Q

According to Erikson’s 5 developmental theory what type of play is associated with adolescents/ teenagers.

A

Team sports, school activities, and peer group activities.

115
Q

What age does the initiative stage occur?

A

4-5 years.

116
Q

What are some examples of foods that should not be given to toddlers?

A

Peanuts, gummies, skittles.

117
Q

What must you establish with school age children during hospitalization?

A

Time because they will try and negotiate time!

118
Q

What do you teach parents to watch for after a pyloromyotomy?

A

To watch for vomiting (dehydration) because it can occur a few days after before it stops.

119
Q

According to Erikson’s 5 developmental theory what type of play is associated with toddlers?

A

Parallel play

120
Q

What are the 5 psychosocial developmental stages Erikson came up with?

A 
Trust
Autonomy
Initiative
Industry
Identity
121
Q

When does the posterior fontanel close?

A

3 months

122
Q

What happens in Type I diabetes?

A

Pancreatic beta cells that produce insulin are destroyed.

123
Q

What is the post op goal for a cleft lip repair?

A

Protect the operative site!

124
Q

How do you assess pain for children?

A

Wong-Baker faces scale

125
Q

What age do infants sit up unsupported?

A

8-9 month

126
Q

After surgery for Hirshsprungs Disease what do you want to monitor for post op?

A

Bowel sounds (keep NPO until they have good bowel sounds)
Surgical site
Also keep parents at bedside for comfort of child

127
Q

What is pyloric stenosis?

A

An obstructive disorder that causes constriction of the pyloric sphinter with obstruction of gastric outlet.

128
Q

What types of food do you want to avoid if you have PKU?

A

Meats!

129
Q

What can happen is hypothyroidism is left untreated?

A

Profound cognitive defects and developmental delays

130
Q

Why are toddlers at risk for aspiration when eating?

A

Because they are often running around.

131
Q

What causes iron deficiency anemia?

A

An inadequate supply of dietary iron.

132
Q

What should be avoided in older children with GER?

A

Caffeine, chocolate, spicy foods, citrus, peppermint, tobacco and alcohol.

133
Q

What are the signs and symptoms of acute lymphoid leukemia (ALL)?

A 
Fever
Pallor
Tachycardia
Lethargy
Malaise
Large joint/bone pain
Petechiae (purple spots from bleeding under skin)
Frank bleeding (rectal bleeding)
Liver enlargement
Spleen enlargement
Enlarged lymph nodes
134
Q

Why is it important to monitor the stool of an infant with intussusception prior to surgery?

A

Because if the stool is normal thatn the intussusception has reversed and the surgery can be canceled.

135
Q

Why can’t laxatives, enemas or heat be used for kids with appendicitis?

A

Because these all stimulate bowel motility and increases risk of perforation.

136
Q

When an acute lymphoid leukemia (ALL) is getting chemotherapy what do you need to watch for?

A

Anaphylaxis shock signs and symptoms which are:
Cyanosis
Hypotension
Wheezing
Uticaria (Stop drug treatment immediately)

137
Q

According to Erikson’s 5 developmental theory what type of play is associated with school age children?

A

Cooperative play like games with rules and collective things

138
Q

What is the cause of hypothyroidism?

A

Thyroxine (t4) is not produced.

139
Q

What are some physical signs and symptoms and risks for patients with acute lymphoid leukemia (ALL)?

A

Increased risk for infection
Imbalanced nutrition
Decreased appetite
Hair loss

140
Q

How do you administer iron to young children?

A

Use a dropper and do not get on tongue!!

141
Q

What are triggers of a sickle cell crisis?

A

Dehydration
Cold
Stress

142
Q

What must be checked during pre op for patients with pyloric stenosis?

A

Make sure there is no dehydration and metabolic alkalosis occurring.

143
Q

Describe the feeding post op from a pyloromyotomy.

A

It will resume in 4-6 hours after. The feedings will be small and frequent. Feedings will be with glucose water and electrolytes (pedialyte)

144
Q

What are the two reasons why you start infants with the iron-fortified cereal?

A

Idiopathic type 1 and because its the least allergenic and the iron storages in the body have been depleted.

145
Q

What age does an infant triple their birth weight?

A

12 months

146
Q

According to Erikson’s 5 developmental theory what type of play is associated with babies?

A

Solitary play or onlooker play

147
Q

According to Erikson’s 5 developmental theory what are two toys that are appropriate for toddlers?

A

Toys that make noise or toys that can be pushed or pulled.

148
Q

What age does the autonomy stage occur?

A

1 year -3 years old

149
Q

What are signs and symptoms of sickle cell anemia?

A

Fever
Pain
Tissue engorgement

150
Q

What is the mortality rate of surgical complications in infants with Hirshsprungs Disease?

A

20 %

151
Q

Why are teens typically in trouble with nutrition?

A

Because they are prone to eating fast food and high fat foods like burgers and pizza.

152
Q

What are signs and symptoms of drug toxicity to watch for with acute lymphoid leukemia (ALL) patients?

A 
Nausea/ vomiting
Anorexia
Mucosal ulceration
Neuropathy
Hemorrhagic cysts
Alopecia
Mood changes
Moon face
153
Q

At what age or weight is a cleft palate typically repaired?

A

1 year or 20 lbs

154
Q

When do you introduce iron-fortified cereal or formula?

A

5-6 months

155
Q

Describe the surgical procedure used for pyloric stenosis.

A

Pyloromyotomy with a RUQ incision. It can be done laparoscopically which reduces the surgical time, feeding delay, and discharge.

Mom, baby and pediatrics (4 decks)

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