Exam Two scary COPY COPY Flashcards
When is birth weight doubled?
4-6 months
When is birth weight trippled?
1 year
How long should babies be breast fed?
First two years of life
Why are babies supplemented with Vitamin D? How much?
Prevention of rickets, 400u
Concern for cow’s milk in an infant?
GI bleeds, anemia, interfered with absorption of nutrients
When to start introducing complementary foods?
No earlier than 6 months
How much milk should a toddler consume per day?
16-24oz
Max amount of milk per day
32oz
How much juice per day?
4-6oz
How many teeth do children loose? When do they start loosing them.
32 teeth
beginning at age 6
What percentage (BMI) is considered low?
<5%
Percentile of BMI to be considered obese:
85th -95th percentile
How much daily activity is needed per day?
30-60 minutes
Explain why folic acid is needed for pregnant women:
Decreases risk of spina bifida in infants
Steatorrhea, chronic diarrhea, growth impairment and abdominal distention are clinical manifestations of:
Celiac disease
How would you explain celiac disease to a parent?
Intolerance for gluten; which is a protein found in wheat, rye and oat products.
A child was recently diagnosed with Celiac disease. Their parent questions how long to cut out gluten from their child’s diet?
forever and ever and ever
A parent bring’s in their 12mo child who has began refusing food, sleeping erratically, becoming irritable. When you weigh the child, it appears the child has lost 4kg putting them in <5th percentile on the BMI scale. What is you suspicion?
Avoidant/Restrictive food intake disorder
What are physical symptoms that accompany the diagnosis of Anorexia Nervosa?
Cold intolerance, abd discomfort, bloating, irregular menses, malnutrition
Treatment planning for Anorexia would include:
Fix malnutrition
When increasing calories for sports nutrition what macronutrient would you not increase?
Fat
A mother comes in wondering why her child cannot stop crying. After labs and an assessment it reveals that there is:
Multiple bruises in stages of healing
Scald burns in stages of healing
Rope marks
The nurse’s first priority for this patient is… because…
Safety!!! ABUSE
The condition in which a parent involves fabrication of symptoms of an illness of their child:
Factitious Disorder
What is the most common source of lead exposure for preschool children?
PAINT
Ligaments
Bone to bone
Tendons
Bone to muscles
Stronger than bones
Which cast is used for congential club foot?
How long is it used for?
Ponseti Cast
3-4 years
What are 3 teachings that you as a nurse will teach a parent about cast care?
Assess circulation
Cast care (dry/ raise)
What are causes of developmental dysplasia?
IU position
breech
maternal estrogen
What is the treatment for dysplasia? Education:
Pavlik harness
T-shirt under harness
T or F
The pavlik harness allows hip flexion and abduction.
True
NOE EXTENSION OR ADDUCTION
What are the stages of Legg-Calve Perthes?
1) avascular, asymptomatic
2) pain, limited ROM (deformity and fx)
3) reossification
4) necrosis
After an XRAY reveals the femoral head displaced from the femoral neck. The nurse suspects which condition:
SCFE
Slipped Capital Femoral Epiphysis
What would a patient suffering from SCFE complain of?
pain in hip
limited ROM
inflamed edematous synovial membrain
callous formation
What are the categories and the degrees of scoliosis? Include their treatment
Mild 10-20 -> PT
Moderate 20-40 ->brace
Severe 40-50 -> spinal fusion
Uneven shoulders, prominent scapula, truncal asymmetry and one sided rib hump are manifestations of:
Scoliosis
Why is a PICC line needed for osteomyelitis?
IV antibiotics
–> given 3-6w
A 4 month-old patient comes in to the ER with the 3rd fracture this month. Upon assessment, the nurse notices blue sclerae, which can be a manifestation of:
Osteogenesis imperfecta
What should a child with osteogenesis diet consist of?
High vitamin C, D, and calcium.
What is the most important assessment when caring for fractures?
Circulatory
Purpose of traction
Immobilization
Craving for ice (PICA) can be associated with which deficiency?
Iron
Ferrous sulfate is an indicated prescription when hgb/hct are which values?
HGB < 11.3g/dl
HCT <34%
A father calls nurse on call about their child’s stool being black. The parent states the child is taking iron supplements. The nurse would say:
This is a normal finding of that medication.
What are prevention techniques for sports injuries?
Warm up/cool down
Correct techniques
Gradual increase in time and intensity
What organ is the first to clump resulting from a sickle cell crisis?
Spleen
What three factors can prevent blood from further sickling?
Oxygenation, transfusion and hydration
T or F
A child with sickle cell receives the gene from one parent
False bitch HAHAHAHAH
How long will a child with sickle cell be on Penicillin?
Until age 5
What is Deferoxamine used for?
Iron overload
What benefit does Hydroxyurea have for Sickle Cell patients?
Decreases production of abnormal cells.
Deficiency of factor
(a) VIII
(b) IX
(c) XI
(d) vWF
HEMOPHILIA
a is a
b is b
c is c
d is Von willebrand
A nurse would question which order for a patient with sickle cell?
Hydroxyurea
Oxygen
Aspirin
Transfusion
Replacement factors
Aspirin
What is the SA node?
Pacemaker of the heart
After insertion of a PICC line, their cardiac monitor shows a arrhythmia. What happened
Well remember… You cannot tell NSR from a cardiac monitor
IF EKG SHOWS ARRHYTHMIA Cath touching SA node
What is cardiac output?
Blood ejected from LV each minute
What is the difference between S1 and S2
S1 tricuspid and mitral
S2 aortic and pulmonic
Where do you assess heart rate for pediatric?
Apex
What is the best placement for a blood pressure?
Right arm – she said this like 20 times so remember this one
What are (4) abnormal neurological assessment findings in infants?
Disinterest in feeds
Weak suck
Irritability
Weak cry
What two infant heart factors double at birth?
Metabolic rate and oxygen consumption
When does the ductus arteriorsis close after birth?
10hr-21 days
What are (3) interventions post operative cardiac cath?
Direct pressure 15 minutes after cath removal
Supine positioning
Dressing assessment
CHF infant (3)
Tire easily and diaphoresis (with feeds)
Mottling
Weight loss/lack of wt gain
CHF toddler/children (3)
Activity intolerance
Dyspnea
Peripheral edema
CHF older children (3)
Edema
Thready pulse
Failure to thrive
Pharmacology for CHF
(3)
With reasoning
Diuretics for fluid excretion
ACE-I decrease BP/work of heart
Digoxin which slows HR to increase cardiac filling time and contractility
Atrial Septal Defect closure takes:
4 years
Manifestations of Ventricular Septal Defect
CHF, pulm infection, failure to thrive
Assessment of chest tube (3)
Crepitus – bubbling under skin
Vaseline gauze
2 hemostats
What does patent ductus arteriosus sound like?
LOUD
Medication for PDA in premature infants?
IV ibuprofen/indomethacin
Manifestations of Coarctation of the Aorta
Cardiomegaly
Low BP in legs high in arms – pulse bounding upper, weak lower
Manifestations of decreased pulmonary blood flow (3)
Polycythemia
Risk thromboembolism
No response to oxygen
Pulmonary stenosis clinical therapy
Dilation by balloon valvuloplasty
Lifelong infective endocarditis prophylaxis
Tetralogy of Fallot (4)
Pulmonary stenosis
Right V hypertrophy
Overrriding aorta
VSD
What to do when tet spell epidose?
KNEE TO CHEST GO CRAZYYYYYYY SQUAT FOR YOUNGER KID
THEN
o2, mophine, BB, PRBC
How to treat infective endocarditis:
antibiotics 4-8 weeks
Two clinical manifestations of rheumatic fever:
postive strep A test
elevated antistep-O titer
Aimless movement and facial grimacing is considered what of rheumatic fever
Sydenham chorea
What med to avoid with RHY?
Aspirin –> encephalopathy
Acute febrile systemic vascular inflammatory illness:
Kawasaki
Kawasaki Sx (4)
Fever >5 days
Conjunctival hyperemia
Dry, red lips
Maculopapular rash
What med reduces risk of coronary artery aneurysm in Kawasaki?
Immune Globulin
SVT treatment
Vagal maneuvers or
( ice to face )
Cardioversion
Adenosine
Ablation
Infection Conjunctivitis causes
Ophthalmia neonatrium from mom at birth
–> prevented with erythromycin
Bacterial Conjunctivitis symptoms
edema of eyelid, red, big lymph glands, purulent drainage
Viral conjuctivitis
Herpes
–> IV acyclovir
Treating conjunctivits
CONTAGIOUS
Antibiotics for 24hr
Hyperopia
far sighted,
myopia
near sighted
Amblyopia
reduced vision of the eye
Strabimus
lazy eye
Clouding of lens
Cataracts
Retinopathy of prematurity causes/treatment
Oxygen therapy!!!
Respiratory distress
Assisted ventilation
TREAT WITH LASER
Otitis Media
EAR INFECTION
Pain during sleep
Hearing impairment infant
no startle reflex
Toddler hearing impairment
unintelligible speech
School age hearing impairment
repeat instruction, inappropriate answers
Epistaxis treatment
Upright with head forward
Squeeze nares below nasal bone
Nasopharyngitis
URI –> virus/bacteria
s/sx viral sx
T or F
Antibiotic for viral NasoPharngitis
F
only for bacteria bitch
Pharyngitis sx/tx
HA, strep, abrupt onset, red pharynx, painful swallowing
treat acetaminophen, soft food, cold food, ice chip
Tonsilitis sx
frequent throat infections, persistent redness
greater than 38.3c fever
When is tonsillectomy recommended?
7 in 1 year
5 in 2
3 is 3
Dental emergency you take the child to the hospital via car
EMS you stupid
