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Nursing school level 2 > Final exam PEDS > Flashcards

Final exam PEDS Flashcards

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1
Q

what were the reasons for the development of family centered care

A

recognition that the emotional needs of hospitalized children went unmet
parents were not involved in the direct patent care of their children
children were not prepared for procedures and tests

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2
Q

exception to confidentiality

A

someone is hurting them, they want to hurt someone, they want to hurt themselves

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3
Q

during fetal development what is the fastest growing body part

A

the head

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4
Q

during childhood what is the most rapidly growing body part

A

the legs

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5
Q

most important influence on growth

A

nutrition

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6
Q

APP nutrition recommendations

A

breastfeeding for all infants until 1 year of age, vitamin D supplement 400iu/day for exclusively breast fed infants and for those who are formulae fed less than 32 ounces a day

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7
Q

development proceeds from the

A

simple to the complex and from the general to the specific

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8
Q

development occurs in a _________ and a ________ progression

A

cephalocaudal and proximodistal progression

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9
Q

cephalocaudal

A

head to toe

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10
Q

proximodistal

A

from center outward

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11
Q

which type of child is more prone to behavioral problems in early and middle childhood

A

slow to warm up child

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12
Q

birth weight increases by _____ by 1 year

A

birth weight triples by 1 yr

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13
Q

birth length by 1 yr

A

birth length increases by 50% at 1 yr

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14
Q

posterior fontanel closes by

A

6-8 weeks (2 months)

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15
Q

anterior fontanel closes by

A

12-18 months

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16
Q

grasp reflex

A

2-3 months

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17
Q

palmar grasp

A

using the whole hand to grasp large objects 6-8 months

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18
Q

pincer grasp

A

using thumb and index finger 8-9 months

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19
Q

should have head control

A

4-6 months

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20
Q

should be rolling over

A

to back by 5 months and to belly by 6 months

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21
Q

should be sitting by

A

sit supported by 4 months and sit unsupported by 8 months

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22
Q

baby should not have solid food until

A

4-6 months

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23
Q

no juice until

A

6 months

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24
Q

immunizations are given at

A

2 months, 4 months, and 6 months

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25
Q

Hep b given

A

at birth and 4 and 6 months

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26
Q

babies can receive flu vaccine at

A

6 months

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27
Q

1 year vaccines

A

pneumococcal 13, MMR, varicella, and hep A

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28
Q

internal ear is still straight and short, and larger lymphoid tissue is present which causes what to be common in toddlers

A

otitis media, tonsilliti, and URIs

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29
Q

SAFE PAD

A

suffocation/sleep position, asphyxia/animal bites, falls, electrical burns, poisoning, automobile safety, drowning

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30
Q

social development in toddlers

A

differentiation of self, recognition body image, and comprehend language much more

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31
Q

terrible twos

A

part of growing, exerting self control, and independence

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32
Q

what is the most distinguishing characteristic of play

A

imitation

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33
Q

parallel play

A

play independently but among other children

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34
Q

most chronic disease in children in the us

A

tooth decay

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35
Q

sequence of physical exam in infant

A

if quiet auscultate first then proceed in head to toe fashion, perform traumatic procedure last, elicit reflexes as body part is examined

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36
Q

sequence of physical exam in toddler

A

inspect through play, introduce equipment slowly, auscultate, percuss, palpate when quiet

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37
Q

children in the 5th percentile of BMI

A

underweight

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38
Q

healthy weight of BMI

A

5th - 84th percentile

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39
Q

deceleration in growth chart indicate

A

changing health status

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40
Q

significant head lag after 6 months strongly indicates

A

cerebral injury

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41
Q

bossing

A

frontal enlargement

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42
Q

1 year visual acuity

A

20/40-20/70

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43
Q

4 year visual acuity

A

20/30-20/40

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44
Q

5 year visual acuity

A

20/20-20/30

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45
Q

testing sucking reflex

A

Touch infants lip, cheek, or corner of mouth with nipple of finger; infant turns head toward stimulus and opens mouth

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46
Q

moro reflex

A

place infant supine on flat surface. clap your hands and baby should extend arms our and look startled. begins disappearing at 8 wks

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47
Q

babinski reflex

A

stroke upward on sole beginning at heel. toes should hyperextend and fan outward

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48
Q

normal neonatal temp

A

97.7-98.6 F

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49
Q

hypoglycemia occurs with levels less than

A

45 mg/dL

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50
Q

rapid utilization of brown fat can lead to

A

metabolic acidosis/hypoglycemia

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51
Q

most commonly used behavioral pain measure for below 3 years old

A

FLACC

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52
Q

children metabolize drugs _______ than adults

A

more rapidly

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53
Q

aspirin in children is associated with

A

reye syndrome

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54
Q

differences in respiratory systemin newborns

A

upper airway is shorter and more narrow, larynx is more flexible, larger tonsils and lymph tissue, underdeveloped intercostal muscles

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55
Q

symptoms of infectious mononucleosis

A

fever, exudative pharyngitis, lymphadenopathy (occipital), hepatosplenomegaly

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56
Q

what do you have to tell kids not to do during infectious mononucleosis

A

no contact sports/play for 4 weeks due to splenomegaly

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57
Q

treatment for infectious mononucleosis

A

rest, nutrition, and supportive treatment

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58
Q

laryngomalacia

A

congenital laryngeal cartilage abnormality that causes upper airway obstruction

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59
Q

laryngomalacia treatment

A

will resolve without treatment by 18-24 months of age

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60
Q

croup syndrome

A

mucosal inflammation and edema causing narrowing of the airway

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61
Q

treatment for croup

A

racemic epinephrine - dexamethasone

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62
Q

symptoms of epiglottitis

A

drooling, muffled voice with frog like croaking on inspiration, fever, sore throat, irritable

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63
Q

thumb sign

A

enlarged epiglottis on x ray

64
Q

laryngotracheobronchitis

A

a type of croup characterized by hoarseness and cough described as barky

65
Q

most common cause of hospitalization under 1 year of age

A

RSV - respiratory syncytial virus

66
Q

reagant testing

A

nasal swab

67
Q

pertussis

A

whooping cough

68
Q

whooping cough prevented by

A

vaccine

69
Q

what causes chronic lung disease of infancy

A

neonates receive high flow oxygen or ventilator which causes damages and thickening of the lungs

70
Q

mild intermittent asthma

A

symptoms less than twice per week

71
Q

mild persistent asthma

A

symptoms more than twice per week but less than once per day

72
Q

moderate persistent asthma

A

symptoms more than twice per week

73
Q

severe persistent asthma

A

continual symptoms

74
Q

cystic fibrosis

A

autosomal recessive disorder of the exocrine glands that leads to abnormal accumulation of viscous and mucus

75
Q

characteristic of cystic fibrosis

A

chloride production by sweat glands

76
Q

normal chloride sweat test compared to cystic fibrosis

A

normal = 40 mEq/L and cystic fibrosis is 60 mEq/L

77
Q

cystic fibrosis and the GI tract

A

thick mucus in pancreatic duct blocks enzymes responsible for digestion of nutrients this decreases release of amylase, trypsin and lipase

78
Q

growth of the long boned occurs at the

A

epiphysis

79
Q

varus deviation

A

foot turns in

80
Q

valgus deviation

A

foot turns out

81
Q

osteogenesis imperfecta

A

also known as brittle bone disease

82
Q

bone healing and remodeling in early childhood

A

4 weeks

83
Q

bone healing and remodeling in later childhood

A

6-8 weeks

84
Q

bone healing and remodeling in adolescence

A

8-12 weeks

85
Q

clinical manifestations of osteogenesis imperfecta

A

osteoporosis, excessive bone fragility, blue sclera, discolored teeth, conductive hearing loss by age 20-30, skin may appear translucent

86
Q

therapeutic management of muscular dystrophy

A

maintenance of ambulation and independence, surgery, bracing, physical therapy

87
Q

most common anomaly of congenital heart disease

A

ventricular septal defect

88
Q

what is acyanotic heart defect

A

blood is shunted (flows) from the left side of the heart to the right side of the heart due to a structural defect (hole) in the interventricular septum

89
Q

what is cyanotic heart defect

A

result in a low blood oxygen level

90
Q

what happens with acyanotic heart defect

A

increase pulmonary blood flow and obstruction of blood flow from ventricles

91
Q

what happens with cyanotic heart defect

A

decrease pulmonary blood flow and mixed blood flow

92
Q

increased pulmonary resistance in VSD causes

A

RV hypertrophy and if RV cannot accommodate workload than the RA may also enlarge

93
Q

VSD manifestations

A

s/s of failure to thrive and/or respiration infection with s/s of CHF. holosystolic murmur

94
Q

coarctation of the aorta

A

narrowing of the aorta typically near the insertion of the ductus arteriosus

95
Q

coarctation of the aorta manifestations

A

high blood pressure and bounding pulses in the arms and absent femoral pulses with cool lower extremities. some may show signs of CHF

96
Q

tetralogy of fallot includes what defects

A

VSD
Pulmonic stenosis: narrowing at the entrance of the pulmonary arteries
Overriding aorta
RV hypertrophy

97
Q

hypoplastic left heart syndrome

A

underdevelopment of the left side of the heart

98
Q

Kawasaki disease

A

acute systemic vasculitis of unknown cause

99
Q

Kawasaki disease manifestation

A

fever for more than 5 days with edema changes in extremities, bilateral conjunctival injection, changes in oral mucous membranes, polymorphous rash, and cervical lymphadenopathy (must have 4 of the five)

100
Q

fifth disease manifestations

A

maculopapular rash on truck and extremities. fiery red, edematous rash on cheeks “slapped cheek”

101
Q

s/s of coxsackie virus

A

fever, cold symptoms, sore throat, vesicles in mouth palms and feet (hand, foot and mouth disease)

102
Q

complications of mumps

A

hearing loss, orchitis, oophoritis, arthritis

103
Q

s/s mumps

A

swelling of the neck chin area

104
Q

sixth disease is called

A

roseola infantum

105
Q

roseola infantum (sixth disease) s/s

A

erythematous maculopapular rash that shows up when fever goes away

106
Q

rubella rash

A

pinkish rose maculopapular exanthema that begins on face, neck and spreads downward to include the entire body within 1-3 days

107
Q

three Cs of measles

A

coryza, cough and conjunctivitis

108
Q

impetigo lesions

A

common around nose and mouth

109
Q

tinea is classified according to

A

the part of the body that it is affecting

110
Q

pediculosis capitus

A

head lice

111
Q

mild dehydration s/s

A

watery diarrhea, cap refill less than 2 sec, slight increase in thirst, normal urine specific gravity

112
Q

moderate dehydration s/s

A

abnormal skin turgor, 2-4 sec cap refill, thirst, increase in pulse, dry mucous membrane

113
Q

severe dehydration s/s

A

tented skin, sunken fontanel, cap refill greater than 4 sec, extreme thirst, tachycardia, anuria

114
Q

mild dehydration wt loss in infants and children

A

infants - 3-5%

children 3-4%

115
Q

moderate dehydration wt loss in infants and children

A

infants - 6-9%

children - 6-8%

116
Q

severe dehydration wt loss in infants and children

A

10% weight loss in infants and children

117
Q

bilious vomitting implies

A

disorder of motility or distal blockage

118
Q

Hirschsprung disease

A

congenital aganalionic megacolon - results in mechanical obstruction on the intestine

119
Q

s/s of Hirschsprung disease

A

distended abdomen, feeding intolerance, bilious vomiting, delay in passage of meconium or constipation since birth

120
Q

most common cause of intestinal obstruction in children between 3 months and 3 years

A

intussusception

121
Q

sign of intussusception

A

stool that looks like currant jelly

122
Q

Hypertrophic Pyloric Stenosis

A

The circumferential muscle of the pyloric sphincter becomes thickened, resulting in a narrowing of the pyloric channel and obstruction

123
Q

diagnosis of Hypertrophic Pyloric Stenosis

A

olive like mass that is easily palpated, non bilious vomiting 30-60 min after eating, ultrasound

124
Q

enuresis

A

Common troublesome disorder defined as the intentional or involuntary passage of urine into the bed, usually at night

125
Q

vesicoureteral reflux (VUR)

A

Abnormal retrograde flow of urine into ureters likely to be associated with kidney infections

126
Q

wilms tumor

A

nephroblastoma which is the most common malignant renal and intraadbdominal tumor of childhood

127
Q

most common solid tumor in children

A

brain tumors

128
Q

brain tumors typically involve

A

cerebellum and brainstem

129
Q

most common cause of bacterial meningitis in those less than 2 months

A

Group B streptococcus

130
Q

kernig’s sign

A

stiffness of hamstring causes inability to straighten leg

131
Q

brudzinski’s sign

A

severe neck stiffness causes hip/knee flexed when the neck is flexed

132
Q

diagnostic for meningitis

A

lumbar puncture with high WBC and low glucose.

133
Q

reyes syndrome

A

acute encephalopathy with fever and impairs hepatic function. follows viral infection usually

134
Q

reyes syndrome associated with

A

aspirin therapy

135
Q

most common pediatric neurologic disorder

A

seizure disorder

136
Q

epilepsy

A

condition characterized by 2 or more unprovoked seizures

137
Q

status epilepticus

A

Continuous seizure that lasts more than 30 minutes or a series of seizures from which the child does not regain pre-seizure LOC

138
Q

initial management of status epilepticus

A

directed toward ABCs

139
Q

children with epilepsy are ____ more likely to die than those with a normal neurologic status

A

22 times more likely

140
Q

72% of those who experience a second seizure will

A

continue having additional seizures

141
Q

nursing management after seizure

A

time postictal state, check for breathing, keep on side, remain with child, do not give food or liquids until fully alert, and determine factors that occurred before seizure/triggers

142
Q

febrile seizures

A

simple febrile seizures occur in children 6 months - 5 yrs with no preexisting neurologic abnormality

143
Q

hydrocephalus

A

imbalance on the production and absorption of CSF in the ventricular system. CSF accumulates within the ventricular system, usually under pressure, causing dilation of the ventricles

144
Q

clinical manifestations of Monroe Kelly doctrine

A

head enlargement, bulging fontanel, s/s of intracranial pressure

145
Q

shunt complications

A

infection (greatest risk 1-2 months after placement)- meningitis and ventriculitis or greatest concern

146
Q

anterior pituitary hormones

A

growth hormone, prolactin, ACTH, TSH, FSH, LH

147
Q

posterior pituitary hormones

A

antidiuretic hormone (ADH) and oxytocin

148
Q

hypopituitarism can lead to

A

absence or regression of secondary sex characteristics, growth hormone deficiency, hypo/hyperthyroidism, adrenal hypofunction

149
Q

most common endocrine problem of childhood

A

hypothyroidism

150
Q

most common metabolic disease in children

A

diabetes

151
Q

3 polys of DM

A

polyuria, polydipsia, and polyphagia

152
Q

ketoacidosis

A

body converts glycerol in the fat cells to ketone bodies

153
Q

5 findings in DKA

A 
pH < 7.30
Serum HCO3 < 15
\+ ketonuria or ketonemia
Anion gap > 10mEq/L
BG > 250
154
Q

DKA labs

A 
Blood glucose >250
Low pH
Low HCO3
Low pCO2
Mod-Lg Ketones in UA
155
Q

what electrolyte replacement is needed for DKA

A

K

Nursing school level 2 (15 decks)

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