Exam 4 Flashcards
1
Q
cardiac output formula
A
CO = HR x SV
2
Q
what needs to be done if there is stenosis or coarctation?
A
balloon dilation
3
Q
if a child has fetal alcohol syndrome how likely are they to have CHD?
A
50%
4
Q
if the mother has rubella in the first 7 weeks of pregnancy, how likely is the child to have CHD?
A
50% of defects
5
Q
right-sided heart failure
A
rest of body is affected
6
Q
left-sided heart failure
A
lungs are affected
7
Q
acyanotic CHD
A
- includes ASD and VSD
- inc. pulmonary blood flow
- obstruction to blood flow from ventricles
8
Q
cyanotic CHD
A
- decreased pulmonary blood flow
- mixed blood flow
9
Q
what are increased pulmonary blood flow defects?
A
- atrial septal defect
- ventricular septal defect
- patent ductus arteriosus
10
Q
patent ductus arteriosus
A
closes at first cry
11
Q
what does indomethacin do for PDA?
A
closes it
12
Q
what does prostaglandin do for PDA?
A
opens it
13
Q
what are some obstructive defects of the heart?
A
- coarctation of the aorta
- aortic stenosis
- pulmonic stenosis
14
Q
how do you fix an obstructive defect?
A
balloon dilation
15
Q
kawasaki disease
A
inflammation of all vessels: clotting
16
Q
clinical manifestations of kawasaki disease
A
- high fever
- “strawberry” tongue
- edema of hands and feet
- extreme irritability
- arthritis
- coronary complications
17
Q
what meds do you give for kawasaki?
A
- high dose aspiring - dec. clotting
- steroids
- IV Ig
18
Q
naloxone - narcan
A
reversal for opioid OD
19
Q
HEADS assessment
A
Home
Education
Activity
Drugs
Sexuality activity/identity
Suicide/depression
20
Q
ages of adolescence
A
13-18
21
Q
what is male height spurts in relation to females?
A
theirs is 2 years later than girls
22
Q
what occurs during puberty?
A
- heart, blood volume, and systolic BP increase
- HR decreases
- respiratory vital capacity increases
- change in BMR
23
Q
piaget stage in adolescence
A
formal operational thinking
24
Q
conceptions in adolescence
A
- imaginary audience (everyone is watching)
- personal fable (won’t happen to me)
25
erikson stages in infants
trust vs. mistrust
26
erikson stages in toddlers
autonomy vs. shame
27
erikson stages in preschoolers
initiative vs. guild
28
erikson stages in school aged
industry vs. inferiority
29
erikson stages in adolescence
identity vs. role confusion
30
leading cause of death between 15-19
- accidents
- suicide
- homicide
31
what is a good med for acne?
accutane (isotretinoin): category x pregnancy
32
how to treat testicular torsion
surgically to prevent necrosis
33
what drugs can cause gynecomastia?
Ca ++ channel blockers, H2 blockers, ketocanazoles, and marijuana
34
primary amenorrhea
no menses by 17
35
secondary amenorrhea
no menses for 6 months in previously menstruating females
36
causes of primary amenorrhea
- pregnancy
- polycystic ovarian syndrome
- hypothalamic
- effect of exercise on hormones
37
causes of secondary amenorrhea
- most common cause is pregnancy
- stress, chronic illness, polycystic ovarian disease, anorexia, ovarian disturbance, phenothiazines, and heroin
38
how do you treat chlamydia?
antibiotic compiance and notify partners - Health Department reportable
39
what can occur in infants with adolescent mothers?
- higher risk of prematurity
- higher incidence of low birth weights
- potential for developmental delay
- cumulative risk factors for infant
40
in someone with anorexia and bulimia, what could happen?
K+ could decrease and they can become dehydrated
41
for brain development what do kids need to consume?
fat; give whole milk
42
PERRLA
Pupils Equal
Round
Reactive to Light
Accommodation
43
if a child has a GCS of 8 what should you do?
intubate
44
what happens to the heart in neurogenic shock?
bradycardia
45
what kind of things increase ICP?
crying, lights/stimuli, pain, fever, suctioning, moving patient
46
what could be an indicator of closed head injury?
lethargy, VOMITING, can't wake
47
indicators of cushing's triad
- inc. systolic BP
- dec. pulse
- dec. RR
48
indicators of shock
- dec. BP
- inc. pulse
- inc. RR
49
what is more dangerous cushing's triad or shock?
cushing's triad
50
how should the HOB be positioned to help with ICP?
30 degrees
51
what injuries have the highest mortality rate in children 0-4
submersion injuries
52
what would a culture look like if there is an intracranial infection?
- + WBC
- + protein
- dec. glucose (cloudy)
- gram stain +
53
epilepsy
two or more unprovoked seizures
54
reversal for a seizure
lorazepam -> diazepam -> romazican (flumazanil)
55
are lifestyle factors the cause of childhood cancers?
no
56
signs of cancer in children
- pain
- fever
- skin changes
- anemia
- abdominal mass
- swollen lymph nodes
57
difference between anemia, thrombocytopenia, and leukopenia
- anemia = dec. RBC
- thrombocytopenia = dec. platelets
- leukopenia = dec. WBC
* if all are present; pancytopenia
58
if an immunization is given during chemotherapy, what does that mean?
they should be considered inactivated if given 2 weeks before or during chemo. the child should be revaccinated 6 months after chemo is done
59
most common form of childhood cancer
ALL
60
if a child has trisomy 21, what is the chance they will get cancer?
20 times greater
61
what lab results would someone with leukemia have?
- dec. WBC
- + bands
62
what labs would someone with a neuroblastoma have?
catecholamines in urine
63
wilms tumor
tumor of the kidney
64
what is important if you suspect wilms tumor?
don't palpate abdomen; could proliferate tumor
65
signs of a retinoblastoma
- cat's eye reflex is the most common sign
- strabismus is the second most common sign
- red, painful eye
- blindness is a late sign
66
what should you watch for in someone with anemia?
their o2 sats
67
how does the heart function in anemia?
HR increases to try to pump more o2 in the body
68
what is the rule for transfusions in HGB and HCT?
HCB is 8
HCT is 28
69
until blood becomes available, what should the nurse do in the meantime?
start IV and infuse 0.9% NS to replace volume
70
how fast does blood need to be used?
- within 30 minutes of arrival
- can only infuse over 4 hours max
71
what should you do if there is a transfusion reaction?
stop the blood immediately
72
erikson stages in preschoolers
initiative vs. guilt
73
four problems in TOF
- pulmonic stenosis
- overriding aorta
- ventricular septal defect
- right ventricular hypertrophy
74
if there is is increased ICP what will the CSF be like?
- positive for WBC
- low glucose
- high protein
75
treatment for hydrocephalus
VP shunt so it can drain into the belly; serious if gets infected
76
#1 cause of iron deficiency anemia in peds
too much milk; depletes iron stores
77
what should you educate your patient about iron?
- iron stains teeth
- vitamin C helps it absorb
78
treatment for sickle cell
Hydration
Oxygen (do this first)
Pain relief
79
what ages include mandatory reporting?
under 18 and 70 and over
80
if someone is developmentally delayed, do you have to mandatory report?
yes
81
what is the main reason we give TDAP vaccine?
for pertussis
82
what can happen in children if aspirin is given?
Reye's syndrome can occur and liver can be affected
