Final exam PEDS Flashcards
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
2
Q
exception to confidentiality
A
someone is hurting them, they want to hurt someone, they want to hurt themselves
3
Q
during fetal development what is the fastest growing body part
A
the head
4
Q
during childhood what is the most rapidly growing body part
A
the legs
5
Q
most important influence on growth
A
nutrition
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
7
Q
development proceeds from the
A
simple to the complex and from the general to the specific
8
Q
development occurs in a _________ and a ________ progression
A
cephalocaudal and proximodistal progression
9
Q
cephalocaudal
A
head to toe
10
Q
proximodistal
A
from center outward
11
Q
which type of child is more prone to behavioral problems in early and middle childhood
A
slow to warm up child
12
Q
birth weight increases by _____ by 1 year
A
birth weight triples by 1 yr
13
Q
birth length by 1 yr
A
birth length increases by 50% at 1 yr
14
Q
posterior fontanel closes by
A
6-8 weeks (2 months)
15
Q
anterior fontanel closes by
A
12-18 months
16
Q
grasp reflex
A
2-3 months
17
Q
palmar grasp
A
using the whole hand to grasp large objects 6-8 months
18
Q
pincer grasp
A
using thumb and index finger 8-9 months
19
Q
should have head control
A
4-6 months
20
Q
should be rolling over
A
to back by 5 months and to belly by 6 months
21
Q
should be sitting by
A
sit supported by 4 months and sit unsupported by 8 months
22
Q
baby should not have solid food until
A
4-6 months
23
Q
no juice until
A
6 months
24
Q
immunizations are given at
A
2 months, 4 months, and 6 months
25
Hep b given
at birth and 4 and 6 months
26
babies can receive flu vaccine at
6 months
27
1 year vaccines
pneumococcal 13, MMR, varicella, and hep A
28
internal ear is still straight and short, and larger lymphoid tissue is present which causes what to be common in toddlers
otitis media, tonsilliti, and URIs
29
SAFE PAD
suffocation/sleep position, asphyxia/animal bites, falls, electrical burns, poisoning, automobile safety, drowning
30
social development in toddlers
differentiation of self, recognition body image, and comprehend language much more
31
terrible twos
part of growing, exerting self control, and independence
32
what is the most distinguishing characteristic of play
imitation
33
parallel play
play independently but among other children
34
most chronic disease in children in the us
tooth decay
35
sequence of physical exam in infant
if quiet auscultate first then proceed in head to toe fashion, perform traumatic procedure last, elicit reflexes as body part is examined
36
sequence of physical exam in toddler
inspect through play, introduce equipment slowly, auscultate, percuss, palpate when quiet
37
children in the 5th percentile of BMI
underweight
38
healthy weight of BMI
5th - 84th percentile
39
deceleration in growth chart indicate
changing health status
40
significant head lag after 6 months strongly indicates
cerebral injury
41
bossing
frontal enlargement
42
1 year visual acuity
20/40-20/70
43
4 year visual acuity
20/30-20/40
44
5 year visual acuity
20/20-20/30
45
testing sucking reflex
Touch infants lip, cheek, or corner of mouth with nipple of finger; infant turns head toward stimulus and opens mouth
46
moro reflex
place infant supine on flat surface. clap your hands and baby should extend arms our and look startled. begins disappearing at 8 wks
47
babinski reflex
stroke upward on sole beginning at heel. toes should hyperextend and fan outward
48
normal neonatal temp
97.7-98.6 F
49
hypoglycemia occurs with levels less than
45 mg/dL
50
rapid utilization of brown fat can lead to
metabolic acidosis/hypoglycemia
51
most commonly used behavioral pain measure for below 3 years old
FLACC
52
children metabolize drugs _______ than adults
more rapidly
53
aspirin in children is associated with
reye syndrome
54
differences in respiratory systemin newborns
upper airway is shorter and more narrow, larynx is more flexible, larger tonsils and lymph tissue, underdeveloped intercostal muscles
55
symptoms of infectious mononucleosis
fever, exudative pharyngitis, lymphadenopathy (occipital), hepatosplenomegaly
56
what do you have to tell kids not to do during infectious mononucleosis
no contact sports/play for 4 weeks due to splenomegaly
57
treatment for infectious mononucleosis
rest, nutrition, and supportive treatment
58
laryngomalacia
congenital laryngeal cartilage abnormality that causes upper airway obstruction
59
laryngomalacia treatment
will resolve without treatment by 18-24 months of age
60
croup syndrome
mucosal inflammation and edema causing narrowing of the airway
61
treatment for croup
racemic epinephrine - dexamethasone
62
symptoms of epiglottitis
drooling, muffled voice with frog like croaking on inspiration, fever, sore throat, irritable
63
thumb sign
enlarged epiglottis on x ray
64
laryngotracheobronchitis
a type of croup characterized by hoarseness and cough described as barky
65
most common cause of hospitalization under 1 year of age
RSV - respiratory syncytial virus
66
reagant testing
nasal swab
67
pertussis
whooping cough
68
whooping cough prevented by
vaccine
69
what causes chronic lung disease of infancy
neonates receive high flow oxygen or ventilator which causes damages and thickening of the lungs
70
mild intermittent asthma
symptoms less than twice per week
71
mild persistent asthma
symptoms more than twice per week but less than once per day
72
moderate persistent asthma
symptoms more than twice per week
73
severe persistent asthma
continual symptoms
74
cystic fibrosis
autosomal recessive disorder of the exocrine glands that leads to abnormal accumulation of viscous and mucus
75
characteristic of cystic fibrosis
chloride production by sweat glands
76
normal chloride sweat test compared to cystic fibrosis
normal = 40 mEq/L and cystic fibrosis is 60 mEq/L
77
cystic fibrosis and the GI tract
thick mucus in pancreatic duct blocks enzymes responsible for digestion of nutrients this decreases release of amylase, trypsin and lipase
78
growth of the long boned occurs at the
epiphysis
79
varus deviation
foot turns in
80
valgus deviation
foot turns out
81
osteogenesis imperfecta
also known as brittle bone disease
82
bone healing and remodeling in early childhood
4 weeks
83
bone healing and remodeling in later childhood
6-8 weeks
84
bone healing and remodeling in adolescence
8-12 weeks
85
clinical manifestations of osteogenesis imperfecta
osteoporosis, excessive bone fragility, blue sclera, discolored teeth, conductive hearing loss by age 20-30, skin may appear translucent
86
therapeutic management of muscular dystrophy
maintenance of ambulation and independence, surgery, bracing, physical therapy
87
most common anomaly of congenital heart disease
ventricular septal defect
88
what is acyanotic heart defect
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
what is cyanotic heart defect
result in a low blood oxygen level
90
what happens with acyanotic heart defect
increase pulmonary blood flow and obstruction of blood flow from ventricles
91
what happens with cyanotic heart defect
decrease pulmonary blood flow and mixed blood flow
92
increased pulmonary resistance in VSD causes
RV hypertrophy and if RV cannot accommodate workload than the RA may also enlarge
93
VSD manifestations
s/s of failure to thrive and/or respiration infection with s/s of CHF. holosystolic murmur
94
coarctation of the aorta
narrowing of the aorta typically near the insertion of the ductus arteriosus
95
coarctation of the aorta manifestations
high blood pressure and bounding pulses in the arms and absent femoral pulses with cool lower extremities. some may show signs of CHF
96
tetralogy of fallot includes what defects
VSD
Pulmonic stenosis: narrowing at the entrance of the pulmonary arteries
Overriding aorta
RV hypertrophy
97
hypoplastic left heart syndrome
underdevelopment of the left side of the heart
98
Kawasaki disease
acute systemic vasculitis of unknown cause
99
Kawasaki disease manifestation
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
fifth disease manifestations
maculopapular rash on truck and extremities. fiery red, edematous rash on cheeks "slapped cheek"
101
s/s of coxsackie virus
fever, cold symptoms, sore throat, vesicles in mouth palms and feet (hand, foot and mouth disease)
102
complications of mumps
hearing loss, orchitis, oophoritis, arthritis
103
s/s mumps
swelling of the neck chin area
104
sixth disease is called
roseola infantum
105
roseola infantum (sixth disease) s/s
erythematous maculopapular rash that shows up when fever goes away
106
rubella rash
pinkish rose maculopapular exanthema that begins on face, neck and spreads downward to include the entire body within 1-3 days
107
three Cs of measles
coryza, cough and conjunctivitis
108
impetigo lesions
common around nose and mouth
109
tinea is classified according to
the part of the body that it is affecting
110
pediculosis capitus
head lice
111
mild dehydration s/s
watery diarrhea, cap refill less than 2 sec, slight increase in thirst, normal urine specific gravity
112
moderate dehydration s/s
abnormal skin turgor, 2-4 sec cap refill, thirst, increase in pulse, dry mucous membrane
113
severe dehydration s/s
tented skin, sunken fontanel, cap refill greater than 4 sec, extreme thirst, tachycardia, anuria
114
mild dehydration wt loss in infants and children
infants - 3-5%
| children 3-4%
115
moderate dehydration wt loss in infants and children
infants - 6-9%
| children - 6-8%
116
severe dehydration wt loss in infants and children
10% weight loss in infants and children
117
bilious vomitting implies
disorder of motility or distal blockage
118
Hirschsprung disease
congenital aganalionic megacolon - results in mechanical obstruction on the intestine
119
s/s of Hirschsprung disease
distended abdomen, feeding intolerance, bilious vomiting, delay in passage of meconium or constipation since birth
120
most common cause of intestinal obstruction in children between 3 months and 3 years
intussusception
121
sign of intussusception
stool that looks like currant jelly
122
Hypertrophic Pyloric Stenosis
The circumferential muscle of the pyloric sphincter becomes thickened, resulting in a narrowing of the pyloric channel and obstruction
123
diagnosis of Hypertrophic Pyloric Stenosis
olive like mass that is easily palpated, non bilious vomiting 30-60 min after eating, ultrasound
124
enuresis
Common troublesome disorder defined as the intentional or involuntary passage of urine into the bed, usually at night
125
vesicoureteral reflux (VUR)
Abnormal retrograde flow of urine into ureters likely to be associated with kidney infections
126
wilms tumor
nephroblastoma which is the most common malignant renal and intraadbdominal tumor of childhood
127
most common solid tumor in children
brain tumors
128
brain tumors typically involve
cerebellum and brainstem
129
most common cause of bacterial meningitis in those less than 2 months
Group B streptococcus
130
kernig's sign
stiffness of hamstring causes inability to straighten leg
131
brudzinski's sign
severe neck stiffness causes hip/knee flexed when the neck is flexed
132
diagnostic for meningitis
lumbar puncture with high WBC and low glucose.
133
reyes syndrome
acute encephalopathy with fever and impairs hepatic function. follows viral infection usually
134
reyes syndrome associated with
aspirin therapy
135
most common pediatric neurologic disorder
seizure disorder
136
epilepsy
condition characterized by 2 or more unprovoked seizures
137
status epilepticus
Continuous seizure that lasts more than 30 minutes or a series of seizures from which the child does not regain pre-seizure LOC
138
initial management of status epilepticus
directed toward ABCs
139
children with epilepsy are ____ more likely to die than those with a normal neurologic status
22 times more likely
140
72% of those who experience a second seizure will
continue having additional seizures
141
nursing management after seizure
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
febrile seizures
simple febrile seizures occur in children 6 months - 5 yrs with no preexisting neurologic abnormality
143
hydrocephalus
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
clinical manifestations of Monroe Kelly doctrine
head enlargement, bulging fontanel, s/s of intracranial pressure
145
shunt complications
infection (greatest risk 1-2 months after placement)- meningitis and ventriculitis or greatest concern
146
anterior pituitary hormones
growth hormone, prolactin, ACTH, TSH, FSH, LH
147
posterior pituitary hormones
antidiuretic hormone (ADH) and oxytocin
148
hypopituitarism can lead to
absence or regression of secondary sex characteristics, growth hormone deficiency, hypo/hyperthyroidism, adrenal hypofunction
149
most common endocrine problem of childhood
hypothyroidism
150
most common metabolic disease in children
diabetes
151
3 polys of DM
polyuria, polydipsia, and polyphagia
152
ketoacidosis
body converts glycerol in the fat cells to ketone bodies
153
5 findings in DKA
```
pH < 7.30
Serum HCO3 < 15
+ ketonuria or ketonemia
Anion gap > 10mEq/L
BG > 250
```
154
DKA labs
```
Blood glucose >250
Low pH
Low HCO3
Low pCO2
Mod-Lg Ketones in UA
```
155
what electrolyte replacement is needed for DKA
K
