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PEDS$ > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

What is Amblyopia?

A

Poor development in an otherwise normal eye that leads to decreased acuity in one eye and blindness in one or both eyes if not corrected

Also known as lazy eye, can be caused by strabismus.

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2
Q

What are the management strategies for Amblyopia?

A

Screen all preschoolers for visual acuity by age 3, observe for asymmetry of corneal light reflex, correction may include:
* Patching the stronger eye
* Atropine drops in the stronger eye
* Vision therapy
* Eye muscle surgery

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3
Q

What is Conductive hearing loss?

A

Transmission of sound through the middle ear is disrupted

Causes include frequent ear infections and cerumen buildup.

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4
Q

What is Sensorineural hearing loss?

A

Damage to hair cells in the cochlea or along the auditory pathway

Causes include ototoxic medication, meningitis, CMV, rubella, and excessive noise.

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5
Q

What are the symptoms of hearing loss in infants?

A

Do not startle to loud noises, did not babble at 6 months, do not turn their head toward sound

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6
Q

What are the symptoms of hearing loss in older children?

A

Frequently ask to have statements repeated, poor school performance, talk with monotone voice or other abnormal speech quality

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7
Q

What is Infantile glaucoma?

A

An autosomal recessive disorder with obstruction of aqueous humor flow leading to high IOP and results in retinal scarring and optic nerve damage

Symptoms include family history, frequent eye rubbing, corneal clouding, and enlargement of the eyeball.

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8
Q

What is the first-line management for Infantile glaucoma?

A

Surgical intervention

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9
Q

What are the symptoms of Congenital cataracts?

A

Cloudy cornea, absent red reflex in the affected eye

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10
Q

What is the management for Congenital cataracts?

A

Post-op eye patching, elbow restraints, education on administering eye drops, sunglasses needed for UV protection

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11
Q

What is the priority nursing care for children with visual impairment?

A

Promote optimal development by:
* Encouraging use of corrective lenses
* Connecting with educational services
* Encouraging compliance with visual screening appointments
* Education on safety hazards and eye injury prevention

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12
Q

What are the signs and symptoms of Otitis Media?

A

Rubbing/pulling on ear, crying/irritability, fever, dull/red/bulging tympanic membrane, purulent drainage, poor feeding, difficulty sleeping

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13
Q

What is the management for Acute Otitis Media?

A

Acetaminophen and ibuprofen for pain, watchful waiting for viral AOM, antibiotics for severe symptoms

Common antibiotics include Amoxicillin and Ceftriaxone.

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14
Q

What is Tympanostomy/Myringotomy?

A

A surgical procedure for ear tube placement to manage recurrent otitis media

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15
Q

What are the proper techniques for ear drop administration in children?

A

Child <3 yrs: pull pinna down and back; Child >3 yrs: pull pinna up and back

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16
Q

What are the types of skin lesions?

A

Abrasions, lacerations, bites, bruises, burns

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17
Q

What is the difference between accidental and nonaccidental injuries?

A

Accidental injuries occur due to unintentional events, while nonaccidental injuries may result from abuse or neglect

Risk factors for nonaccidental injuries include poverty, prematurity, and parental history of abuse.

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18
Q

What are the signs of sunburn prevention in infants?

A

Infants <6 months should be kept out of direct sunlight, wear hats and sun shirts, and limit sun exposure between 10 am – 4 pm

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19
Q

What are the primary and secondary assessments for burns?

A

Primary: Airway assessment, signs of airway injury, respiratory effort, skin color, pulse strength
Secondary: Burn depth, body surface area (BSA), other traumatic injuries

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20
Q

What is the Parkland formula used for?

A

Fluid calculation based on the total body surface area (TBSA) burned, important for fluid resuscitation in burn care

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21
Q

What are the signs and symptoms of Atopic Dermatitis?

A

Extreme itching, dry scaly pruritic patches, elevated IgE levels, presence of wheezing

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22
Q

What is the management for Atopic Dermatitis?

A

Topical corticosteroids, avoid hot water, use moisturizers, antihistamines for itching

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23
Q

What is Diaper Dermatitis?

A

An inflammatory reaction caused by detergents, soaps, or chemicals affecting the diaper area

Non-candida presents as red, shiny lesions, while Candida presents with deep red lesions and satellite lesions.

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24
Q

What is the management for Acne?

A

Education on avoiding oil-based products, regular cleansing, use of topical medications, emotional counseling if severe

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25
Q

What are the history cues of Immunodeficiency?

A

Four or more episodes of acute otitis media in 1 year, two or more episodes of severe sinusitis, recurrent deep skin or organ abscesses

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26
Q

What lab values are indicative of Immunodeficiency?

A

CBC with differential, elevated IgE, abnormal immunoglobulin levels

Normal ranges include RBC, Hgb, Hct, and WBC counts.

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27
Q

What is the normal CD4 count (T-helper cells) range?

A

447-1,750 cells/uL

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28
Q

What is the normal range for IgG?

A

639-1,349 mg/dL (~75%)

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29
Q

What is the normal range for IgA?

A

70-312 mg/dL (10-15%)

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30
Q

What is the normal range for IgM?

A

56-352 mg/dL (7-10%)

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31
Q

What is the normal range for IgE?

A

0.01-0.04 mg/dL (<1%)

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32
Q

What is the normal range for IgD?

A

0.5-3 mg/dL (<1%)

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33
Q

What is the normal range for Complement C3?

A

80-184 mg/dL

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34
Q

What characterizes Severe Combined Immune Deficiency (SCID)?

A

No T or B-cell function; X-linked autosomal recessive disorder

35
Q

What is another name for Severe Combined Immune Deficiency (SCID)?

A

Bubble Boy Syndrome

36
Q

What is the management priority for SCID?

A

Infection prevention

37
Q

What are the diagnostic findings for SCID?

A
  • Absent T and B-cell function
  • Rare X-linked autosomal recessive disorder
38
Q

What diagnostic labs indicate HIV in children aged 18 months or older?

A

+ ELISA and + Western blot

39
Q

What diagnostic labs indicate HIV in infants less than 18 months born to an infected mother?

A

+ PCR and viral culture

40
Q

What is the pathophysiology of Juvenile Idiopathic Arthritis?

A

Autoimmune or autoinflammatory disease causing inflammatory chemicals to attack the synovium

41
Q

What are common signs and symptoms of Juvenile Idiopathic Arthritis?

A
  • Irritability or fussiness
  • Joint stiffness or pain after inactivity
  • Prolonged fever
  • Macular rash
  • Limping gait
42
Q

What lab findings are common in Juvenile Idiopathic Arthritis?

A
  • Mild to moderate anemia
  • Elevated WBC
  • Elevated ESR and CRP
    • ANA in pauciarticular type
    • Rheumatoid Factor
43
Q

What is the pathophysiology of a Latex Allergy?

A

IgE-mediated response to exposure to latex, can result in anaphylaxis

44
Q

What foods have a 35% risk of cross-sensitivity for latex allergy?

A
  • Kiwi
  • Banana
  • Avocado
  • Chestnut
  • Bell pepper
  • Tomato
  • Peach
  • Fig
  • White potato
45
Q

What are common physical signs of allergic reactions?

A
  • Hives
  • Flushing
  • Angioedema
  • Throat swelling
  • Wheezing
46
Q

What is the management for allergic reactions?

A

EpiPen administration

47
Q

What are the characteristic signs and symptoms of Rubeola (Measles)?

A
  • Maculopapular rash
  • Koplik spots
  • Cough
  • Conjunctivitis
48
Q

What is the management for Rubeola (Measles)?

A
  • Antipyretics
  • Bedrest
  • Fluids
  • Vitamin A for certain age groups
49
Q

What is the causative agent of Pertussis?

A

Bordetella pertussis

50
Q

What are the stages of Lyme disease?

A
  • Stage 1: Erythema migrans, fever
  • Stage 2: Systemic involvement
  • Stage 3: Advanced systemic involvement
51
Q

What is a common symptom of Pediculosis capitis (Head lice)?

A

Extreme pruritus

52
Q

What is the pathophysiology of Leukemia (ALL)?

A

Overproduction of immature WBCs with neoplastic characteristics

53
Q

What are common physical findings in patients with Leukemia (ALL)?

A
  • Low-grade fever
  • Increased bruising
  • Enlarged lymph nodes
54
Q

What lab findings are indicative of Leukemia (ALL)?

A
  • Low Hgb
  • Low Hct
  • Low RBCs
  • Low/high WBCs
  • Low platelets
55
Q

What is the pathophysiology of Wilms tumor (Nephroblastoma)?

A

Malignancy that occurs in the kidneys, usually unilateral

56
Q

What are common physical cues of Wilms tumor?

A
  • Firm abdominal swelling/mass
  • Hematuria
  • Hypertension
57
Q

What is the procedure for Bone Marrow Aspirate (BMA)?

A
  • Apply topical anesthetic
  • Sample typically taken from iliac crest
  • Monitor for bleeding and infection post-procedure
58
Q

What defines neutropenia?

A

Absolute neutrophil count of less than 1,000

59
Q

What are common adverse effects of chemotherapy?

A
  • Mucosal ulceration
  • Alopecia
  • Neutropenia
  • Anemia
60
Q

What is the peak incidence age for iron deficiency anemia in children?

A

12-24 months

61
Q

What are common signs and symptoms of iron deficiency anemia?

A
  • Irritability
  • Headaches
  • Fatigue
62
Q

What should be done to irradiated skin?

A

Wash skin over affected area with mild soap and water, gently pat dry, do not apply lotions/powders/ointments/perfumes, avoid sun or heat exposure to area

63
Q

At what age are fetal iron stores typically depleted?

A

4-6 months

64
Q

List common symptoms of iron deficiency anemia.

A
  • Irritability
  • Headache
  • Unsteady gait
  • Weakness
  • Fatigue
  • Dizziness
  • Shortness of breath
  • Pallor
  • Difficulty feeding
  • Spoon-shaped nails
  • Splenomegaly
65
Q

What laboratory findings are indicative of iron deficiency anemia?

A
  • Low hemoglobin and hematocrit
  • Low reticulocyte count
  • Microcytosis
  • Hypochromia
  • Low iron levels
  • Low ferritin
  • Increased free erythrocyte protoporphyrin
66
Q

What nursing care should be provided for iron deficiency anemia?

A
  • Feed only iron fortified formulas or supplements
  • Encourage breastfeeding mothers to increase iron intake
  • Limit cow’s milk in children over 1
  • Offer financial resources
67
Q

What should parents know about iron supplementation for children?

A
  • Use a properly marked measuring device
  • Place behind teeth to avoid staining
  • Can cause constipation and dark green stool
  • Take with orange juice or vitamin C
  • Do not take with milk products
68
Q

What is the pathophysiology of hemophilia?

A

X-linked recessive deficiency in factor VIII in the clotting cascade

69
Q

What is the role of factor VIII in coagulation?

A

Essential to activate Factor X, responsible for converting prothrombin to thrombin

70
Q

What symptoms indicate hemophilia?

A
  • History of bleeding or bruising
  • Chest or abdominal pain
  • Joint swelling
71
Q

What diagnostic findings are associated with hemophilia?

A
  • Low hemoglobin and hematocrit
  • Prolonged PTT
  • Normal PT and platelets
72
Q

What is the management protocol for bleeding episodes in hemophilia?

A
  • Administer factor VIII slow IV push
  • Apply direct pressure and ice to bleeding areas
  • Elevate affected extremities
73
Q

What education should be provided to families with a child who has hemophilia?

A
  • Maintain regular physical activity
  • Wear a medical ID bracelet
  • Know how to administer Factor VIII at home
74
Q

What is the pathophysiology of sickle cell vaso-occlusive crisis?

A

Hemoglobin S causes red blood cells to take on a sickle shape, leading to clumping and obstructed blood flow

75
Q

List common symptoms of a sickle cell vaso-occlusive crisis.

A
  • Joint pain
  • History of immunizations and blood transfusions
  • Increased heart rate and respiratory rate
  • Acute chest syndrome
  • Splenomegaly
  • Anemia
  • Pallor or jaundice
76
Q

What laboratory findings are characteristic of sickle cell vaso-occlusive crisis?

A
  • Hemoglobin 7-10 mg/dL
  • Presence of sickled RBCs on peripheral smear
  • Elevated platelets, ESR, LFTs, bilirubin, and reticulocyte count
77
Q

What are the complications associated with sickle cell vaso-occlusive crisis?

A
  • Vaso-occlusive crisis
  • Cerebrovascular accident (CVA)
  • Acute chest syndrome (ACS)
  • Sepsis
  • Splenic rupture
  • Reduced visual acuity
  • Chronic leg ulcers
  • Dactylitis
  • Cholestasis
  • Gallstones
  • Priapism
  • Enuresis
  • Delayed growth and development
78
Q

What priorities should be addressed in the management of sickle cell vaso-occlusive crisis?

A
  • Infection prevention
  • Pain control
  • Hydration
  • Hypoxia management
79
Q

What are the risk factors for lead poisoning?

A
  • Age
  • Living in older homes
  • Proximity to busy roads
  • Toys/imported products
  • Poverty/malnutrition
  • Pica
80
Q

List physical cues of lead poisoning.

A
  • Irritability
  • Abdominal pain/cramping
  • Poor appetite
  • Vomiting
  • Ataxia
  • Hematuria
  • New onset seizures
81
Q

What are the recommended screening times for lead poisoning in children?

A
  • 6, 9, 12, 18, and 24 months
  • 3, 4, and 5 years
82
Q

What is the treatment for lead poisoning with blood lead levels greater than 45 µg/dL?

A

Chelation therapy

83
Q

What are the methods of chelation therapy for lead poisoning?

A
  • Oral or IV
  • Succimer
  • Dimercaprol
  • Calcium disodium edetate
84
Q

What monitoring is necessary during chelation therapy for lead poisoning?

A

Ensure adequate fluid intake and monitor intake and outputs

PEDS$ (2 decks)

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