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Pediatrics Final Exam > Final Exam Study Guide & Tutoring > Flashcards

Final Exam Study Guide & Tutoring Flashcards

1
Q

Signs & Symptoms of Respiratory Distress

KNOW THIS!!!!

Respiratory

A

MILD
* Restlessness
* Tachypnea
* Tachycardia
* Diaphoresis

MODERATE
* Nasal flaring
* Retractions
* Grunting / wheezing
* HTN
* anxiety, irritable, mood changes, confusion

SEVERE
* Dyspnea
* Bradycardia
* Cyanosis (LATE sign)
* Stupor, coma

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2
Q

What position do children with severe respiratory distress often sit in?

KNOW THIS!!!!

Respiratory

A

Tripod: leaning forward w/ arms on the legs. Head & neck are extended with jaw thrust foward

  • helps them open their airway
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3
Q

Thumb sign on x-ray is indicative of what disease?

KNOW THIS!!!!

Respiratory

A

Epiglottitis – inflammation & swelling of the epiglottis & larynx

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4
Q

What is epiglottitis & what is the key sign?

KNOW THIS!!!!

Respiratory

A

Inflammation & swelling of the epiglotis & larynx

Key Sign = THUMB SIGN on X-RAY

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5
Q

Asthma (Cause / Patho)

KNOW THIS!!!!

Respiratory

A

Persistent inflammation of the airway causing hyper-responsiveness that leads to excess mucous, swelling, & muscle contraction

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6
Q

Asthma Triggers

Respiratory

A
  • environmental
  • exercise
  • viruses
  • allergens
  • smoke
  • dander
  • feces
  • air pollutants
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7
Q

Medications to Treat Asthma

KNOW THIS!!!!

Respiratory

A

Short-Acting Beta Agonist (SABA)
* albuterol

Corticosteroids
* decadron, prednisone, solumedrol

Anticholinergics
* ipatropium

Adjuncts
* duoneb: albuterol/ipatropium, magnesium sulfate

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8
Q

5-10-5 Rule

Respiratory

A

How to use a Spacer for Asthma:

  • Tilt head back & breath in for 5 seconds
  • Hold breath for 10 seconds
  • Breathe out for 5 seconds
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9
Q

Asthma Rule of Twos

Respiratory

A
  • Do you use your quick-relief inhaler more than 2 times per week?
  • Do you awaken at night due to asthma more than 2 times per month?
  • Do you refill a quick-relief inhaler prescription more than 2 times per year?
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10
Q

Cystic Fibrosis

KNOW THIS!!!!

Respiratory

A

Reduced water movement across cell membranes = blocked airways

  • Inherited disorder, CFTR recessive gene mutation
  • Can cause damage to the lungs, pancrease, gallblader, & liver

Dx: sweat test

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11
Q

How is cystic fibrosis diagnosed?

Respiratory

A

Sweat test

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12
Q

Cystic Fibrosis can also cause damage to what organs?

Respiratory

A
  • lungs
  • pancrease
  • gallbladder
  • liver
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13
Q

Croup

Respiratory

A

Broad class of upper airway illnesses that reslt in inflammation & swelling of the epiglottis & larynx, swelling extends into the trachea & larynx

Cause: can be viral or bacterial
* common in ages 3 months - 3 years

Dx: CXR with steeple sign

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14
Q

Steeple sign is the key CXR finding for the diagnosis of what?

KNOW THIS!!!!

A

Croup

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15
Q

Bronchiolitis

Respiratory

A

Inflammation & obstruction of the bronchioles
* viral or bacterial lower respiratory infection
* #1 cause of RSV

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16
Q

Respiratory Syncytial Virus (RSV)

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Respiratory

A
  • highly contaious viral respiratory infection
  • major cause of bronchiolitis
  • from syncytia or large masses of cells that clog & irritate the airway
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17
Q

Pneumonia

KNOW THIS!!!!

Respiratory

A

Inflammation of bronchioles & alveoli

  • TYPES: viral, bacterial, mycoplasmal (atypical)

*

Signs & Symptoms:
* crackles / rhonchi
* chest pain
* retractions / nasal flaring / grunting
* SOB
* lethargy

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18
Q

Age ranges associated with each of the following developmental groups:

  • Infant
  • Toddler
  • Preschooler
  • School Aged
  • Adolesence

KNOW THIS!!!!

Growth & Development

A
  • Infant = 0 - 12 months
  • Toddler = 1 - 3 years
  • Preschooler = 3 - 6 years
  • School Age = 6 - 12 years
  • Adolescence = 12 - 18 years
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19
Q

4 Types of Parenting Styles

Growth & Development

A

1.) Authoritarian
2.) Authoritative
3.) Permissive
4.) Indifferent

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20
Q

List the different types of play

KNOW THIS!!!!!

Growth & Development

A
  • Solitary play
  • Parallel play
  • Associative play
  • Cooperative play
  • Onlooker play
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21
Q

Associative Play

KNOW THIS!!!!!

Growth & Development

A

Play with same toy side-by-side, and ENGAGE with each other

  • toddler to preschool years (1 - 6 years)
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22
Q

Parallel Play

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Growth & Development

A

Play side-by-side with similar toys, but do NOT engage with eachother

  • toddlers (1-3)
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23
Q

Solitary Play

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Growth & Development

A

Independent Play

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24
Q

Expected Weight gain in infants

KNOW THIS!!!!!

Growth & Development

A
  • 2x birth weight by 5-6 months
  • 3x birth weight by 1 year
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25
Q

Erickson’s Developmental Theory Stages

KNOW THIS!!!!!

Growth & Development

A

My Sexy Girl In Red

*

  • Mistrust vs. Trust = 0 - 1 years
  • Shame vs. Autonomy = 1-3 years
  • Guilt vs. Initiative = 3 - 6 years
  • Industry vs. inferiority = 6 - 12 years
  • Role confusion vs. Identity = 12 - 18 years
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26
Q

Toddler Milestones (1-3)

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Growth & Development

A
  • Anterior fontanelle Closes (12-18 months)
  • build tower with 4 blocks by age 2
  • shows growing ability to walk & walk with ease
  • Dresses self
  • Jumps
  • draws circles & other forms
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27
Q

Preschooler Milestones (3-6)

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Growth & Development

A
  • Brushes teeth
  • Uses utensiles to eat
  • Rides a tricycle
  • Associative & Dramatic Play
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28
Q

School Age Milestones (6-12)

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Growth & Development

A
  • Rides 2 wheeler bike
  • Reads
  • Develops hobbies like musical instrument, board games, video games, etc.
  • mature use of language
  • can concentrate for longer periods
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29
Q

Adolescent Milestones (12-18)

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Growth & Development

A
  • Some lack of coordination (common during growth spurt)
  • New sport / muscle development continues
  • Increasing communication & time with peers
  • variation in age of growth spurts
  • Applys abstract thought & analysis in conversations
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30
Q

Normal Temperature Range in Pediatrics

KNOW THIS!!!!!

A

< 36.5°C
& ≥
38°C

  • 97.7 - 100.4 °F
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31
Q

How do you estimate the “normal” Systolic BP for kids 1+ years old?

KNOW THIS!!!!!

A

90 mmHg + (2 x age in years)

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32
Q

Normal Neonate Vitals (HR, RR, SBP)

KNOW THIS!!!!!

A

HR: 80 - 180

RR: 30 - 60

SBP: < 60 mmHg

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33
Q

Infant Vitals (0 - 1 year) (HR, RR, SBP)

KNOW THIS!!!!!

A

HR: 75 - 160

RR: 30 - 60

SBP: < 70 mmHg

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34
Q

Toddler Vitals (1-3 years) (HR, RR, SBP)

KNOW THIS!!!!!

A

HR: 60 - 110

RR: 22 - 40

SBP: < 90 mmHg + (2 x age in years)

3 Year old normal SBP:

90 + (2 x 3) = 90 + 6 = 96

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35
Q

School Age Vitals (6 - 12 years) (HR, RR, SBP)

KNOW THIS!!!!

A

HR: 60 - 110

RR: 18 - 30

SBP: < 90 mmHg + (2 x age in years)

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36
Q

Adolsecent Vitals (12-18 years) (HR, RR, SBP)

KNOW THIS!!!!

A

HR: 50 - 90

RR: 12 - 16

SBP: < 90 mmHg + (2 x age in years)

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37
Q

Tanner Staging

KNOW THIS!!!!!

Growth & Development

A

Stage 1 (prepubertal): No pubic hair present in either sex
* Male - small penis & testes
* Female - flat chest

Stage 2: soft pubic hair appears
* Male - measurable testes enlargement
* Female - breast buds appear

Stage 3: pubic hair becomes coarser
* Male - penis begins to enlarge in size & length
* Female - breast mounds form

Stage 4: pubic hair begins to cover pubic area
* Male - penis begins to widen
* Female - breast enlargement forms “mound-on-mound” breast contour

Stage 5 (Adult): Pubic hair extends to inner thigh
* Male - penis & testes enlarge to adult size
* Female - breast takes on adult contour

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38
Q

Pain Scale Ages

  • NIPS
  • FLACC
  • Faces / Wong Baker

KNOW THIS!!!!!

A
  • NIPS - up to 1 year old
  • FLACC - up to 4 years old
  • Faces / Wong Baker - ages 4-5 years old
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39
Q

ibuprofen / Motrin Safe Dose

KNOW THIS!!!!

A

10 mg/kg

  • every 6 hours
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40
Q

acetaminophen / Tylenol Safe Dose

KNOW THIS!!!!

A

15 mg/kg

  • every 4-6 hours
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41
Q

Conjunctivitis & the 3 types

KNOW THIS!!!!

HEENT

A

Inflammation of the conjunctiva
* bacterial
* viral
* allergic

42
Q

Key S/S of Bacterial Conjunctivitis

KNOW THIS!!!!

HEENT

A

Purulent Drainage
* “pink eye”

43
Q

Key S/S of Viral Conjunctivitis

KNOW THIS!!!!

HEENT

A

Serous (watery) drainage

  • commonly caused by respiratory infection
44
Q

Key S/S of Allergic Conjunctivitis

KNOW THIS!!!!

HEENT

A

Intense Itching

45
Q

Otitis Media vs. Otitis Externa

KNOW THIS!!!!

HEENT

A

Otitis Media = inflammation of the MIDDLE ear

  • Otitis Externa = inflammation of the OUTER ear (“swimmer’s ear”)
46
Q

Otitis Externa

KNOW THIS!!!!

HEENT

A

Inflammation of the OUTER ear
* swimmer’s ear

47
Q

Otitis Media

KNOW THIS!!!!

HEENT

A

Inflammation of the MIDDLE ear

  • redness / buldging of TM
48
Q

Tonsillectomy

KNOW THIS!!!!

HEENT

A

Surgical Removal of Tonsils

Nursing Care
* fluids
* pain relief
* watch for bleeding / infection
* white / yellow exudate x7 days =1 week normal

49
Q

How do Short Acting Beta-2 Agonists (SABA)s work?

KNOW THIS!!!!

Meds

A

Relaxes smooth muscles leading to bronchodilation

50
Q

How do corticosteroids work?

KNOW THIS!!!!

Meds

A

Decrease inflammation

& help with bronchodilation for asthma patients

51
Q

How do anticholinergics work for asthma?

KNOW THIS!!!!

Meds

A

Inhibits bronchoconstriction and decreases mucus production

52
Q

Precocious Puberty

KNOW THIS!!!!!

Endocrine

A

Sexual development before age 9 in boys & 8 in girls

  • Growth plates close sooner than expected
  • leads to an overall stunted growth due to advanced bone age
53
Q

Hypothyroidism

KNOW THIS!!!!!

Endocrine

A

↓ active levels of thyroid hormone

Tx: levothyroixine

Primary Hypothyroidism
* ↑ TSH
* ↓ T4

54
Q

Addison’s Disease (Adrenal Insufficiency)

KNOW THIS!!!!!

Endocrine

A

Hyposecretion (↓ secretion) of aldosterone & cortisol (ACTH)

STEROID

  • Sodium / Sugar low
  • Tired
  • Electrolyte imbalance
  • Reproductive imbalance
  • lOw BP
  • Increased pigmentation
  • Diarrhea / depression
55
Q

Type 1 Diabetes

KNOW THIS!!!!!

Endocrine

A

Insulin dependent; body’s immune system attacks beta cells (↑ glucose levels)

S/S: Polyuria, Polydipsia, Polyphagia

56
Q

Hypoglycemia in children

KNOW THIS!!!!!

Endocrine

A

Blood glucose < 70 mg/dL

57
Q

What is IC Ratio?

KNOW THIS!!!!!

Endocrine

A

Amount of carbs 1 unit of insulin will cover

58
Q

Signs & Symptoms of Hypoglycemia

KNOW THIS!!!!!

Endocrine

A
  • Pallor
  • Diaphoresis
  • Tremors
  • Dizzy / altered mental status
59
Q

Diabetic Ketoacidosis

KNOW THIS!!!!!

Endocrine

A

Production of ketones (metabolic acidosis) due to insufficient insulin for body demands

  • BG > 200 mg/dL
  • Ketonuria: ketones in urine
  • Ketonemia: ketones in blood
  • pH < 7.30

*

Signs & Symptoms: kussmaul breathing & fruity breath

60
Q

Key signs & symptoms of DKA

KNOW THIS!!!!!

Endocrine

A
  • Kussmaul breathing
  • Fruity breath
61
Q

Hypopituitarism / Growth Hormone Deficiency

KNOW THIS!!!!!

Endocrine

A

↓ pituitary gland activity = ↓ growth hormone secretion

  • biosynthetic hormone injections at night
62
Q

Mild, Moderate, & Severe Dehydration

KNOW THIS!!!!!

Electrolytes / Fluid Balance

A

Mild Dehydration
* < / = 5% (40 - 50 mL/kg) loss of body weight

Moderate Dehydration
* 6-10% (60 - 90 mL/kg) loss of body weight

Severe Dehydration
* > /= 10% (100 mL/kg) loss of body weight

63
Q

4-2-1 Fluid Maintenance

KNOW THIS!!!!!

Electrolytes / Fluid Balance

A
  • First 10 kg = 4 mL/kg/hr
  • Next 10 kg = 2 mL/kg/hr
  • Above 20 kg = 1 mL/kg/hr
64
Q

Normal Sodium (Na+) Level in Kids

KNOW THIS!!!!!

Electrolytes / Fluid Balance

A

135 - 145

65
Q

Normal Potassium (K+) Levels in Kids

KNOW THIS!!!!!

Electrolytes / Fluid Balance

A

3.5 - 5

66
Q

Respiratory Acidosis

KNOW THIS!!!!!

Electrolytes / Fluid Balance

A

↓ pH & ↑ CO2

67
Q

Respiratory Alkalosis

KNOW THIS!!!!!

Electrolytes / Fluid Balance

A

↑ pH & ↓ CO2

68
Q

Metabolic Acidosis

KNOW THIS!!!!!

Electrolytes / Fluid Balance

A

↓ pH & ↓ HCO3

69
Q

Metabolic Alkalosis

KNOW THIS!!!!!

Electrolytes / Fluid Balance

A

↑ pH & ↑ HCO3

70
Q

Normal Ranges for pH, CO2, & HCO3

KNOW THIS!!!!!

Electrolytes / Fluid Balance

A

pH: 7.35 - 7.45

pCO2: 35 - 45

HCO3: 22 - 26

71
Q

Breastmilk Rule of 4s

KNOW THIS!!!!!!

Nutrition

A
  • 4 hours at room temperature
  • 4 days in the fridge
  • 24 hours in freezer
72
Q

Infant Nutrition

KNOW THIS!!!!!!

Nutrition

A

Fluid = 140 - 160 mL/kg/day

73
Q

Toddler Nutrition

KNOW THIS!!!!!!

Nutrition

A
  • 1 tablespoon of food per each year of age
  • whole milk until 2 years, then 2%
74
Q

Adolescent Nutritional Needs / Caloric Intake

KNOW THIS!!!!!!

Nutrition

A
  • Males = 3,000 calories
  • Females = 2,000 calories
75
Q

Glasgow Coma Scale (GCS)

KNOW THIS!!!!!!

Neuro

A
  • Eyes Open (out of 4)
  • Motor Response (out of 5)
  • Verbal Response (out of 6)
76
Q

Increased Intracranial Pressure (ICP)

KNOW THIS!!!!!!

Neuro

A

Excess fluid (blood or CSF) or matter (brain) within the cranium causing pressure buildup due ot proportional imbalance

Causes: tumor, infection, head injury, CSF leak, bleeding

Dx: ICP > 15

77
Q

KEY late signs of increased ICP in kids

KNOW THIS!!!!!!

Neuro

A

Cushing’s Triad
* bradycardia
* irregular respirations
* widened pulse pressure

78
Q

Hydrocephalus

KNOW THIS!!!!!!

Neuro

A

Disturbance in the ciruclation of CSF that causes increased ICP

  • overproduction fo fluid
  • obstruction preventing the normal flow of CSF through the ventricles
  • impaired absorption in subarachnoid space
79
Q

Febrile Seizures

KNOW THIS!!!!!

Neuro

A

Seizures that are triggered by a fever above 101 F (38.3 C)

80
Q

Non-communicating hydrocephalus

KNOW THIS!!!!!!

Neuro

A

Blockage of ventricular system that prevents CSF from entering subarachnoid space

81
Q

What is the main goal of treatment for hydrocephalus?

KNOW THIS!!!!!

Neuro

A

To reduce the intracranial pressure & preserve CNS funciton

82
Q

Cleft Lip/Palate Post-Op Nursing Considerations

KNOW THIS!!!!!

HEENT

A
  • Monitor I&Os
  • Upright for feedings (to prevent aspiration)
  • Use special feeder / nipples
  • Cleanse sutures w/ normal saline
  • avoid supine position
  • Avoid straws & utensils
83
Q

Pyloric Stenosis

KNOW THIS!!!!!

GI

A

Hypertrophy of pyloric muscle causing obstruction of pyloric sphincter
* S/S: felt like an olive in the epigastric region & projectile vomiting

*

Nursing Considerations
* avoid oral feedings
* IV hydration
* I&Os
* education
* NG tube
* daily weights

84
Q

Hirschsprung Disease

KNOW THIS!!!!!

GI

A

Congenital absence of ganglion cells in wall of colon or rectum
* causes colon to become a “megacolon”

S/S: failure to pass meconium in first 48 hours of life, abdominal distention, feeding intolerance, bilious emesis

Dx: hx, bowel pattern, barium enema, rectal suction biopsy

85
Q

What type of enema is used for intussusception?

GI

A

Barium enema

86
Q

Enema test used for diagnosis of Hirschsprung Disease

KNOW THIS!!!!!

GI

A

Barium enema

87
Q

Appendicitis
* S/S
* Tx

KNOW THIS!!!!!!

GI

A

Inflammation of the appendix
* Dx = ultrasound

Signs & Symptoms (PAIN)
* Pain (Mcburney’s Rovsing’s, Psoas, Obturator) (RLQ pain)
* Anorexia
* Nausea
* Temperature
* increased WBC, neutrophil, C-reactive protein

Treatment
* surgical removal

88
Q

Acute Post-Infectious Glomerulonephritis (APG)

KNOW THIS!!!!!

GU

A

Inflammation of the glomeruli in the kidneys; commonly caused by group A beta-hemolytic strep

  • + protein & blood in urine
  • Tx = supportive care
89
Q

Hypospadias

KNOW THIS!!!!!

GU

A

Uretral metaus (opening) located on the ventral (bottom) surface of the penis

90
Q

Nephrotic Syndrome

KNOW THIS!!!!!

GU

A

Alteration in kidney function due to ↑ membrane permeability to proteins

Signs & Symptoms:
* periorbital edema
* proteinuria
* hematuria & ↓ urine output
* irritability
* malaise / anorexia
* HTN

Tx: steroids & BP meds

91
Q

Scoliosis

KNOW THIS!!!!

MSK

A

Lateral curvature of the spine; greater than 10 degrees
* noticible after preadolescent growth

S/S: trunk asymmetry, uneven shoulders & hips, one sided rib hump, prominent scapula

  • mild:10-20% curvature
  • moderate: 20-40% curvature
  • severe: 40-50% curvature
92
Q

Osteomyelitis

KNOW THIS!!!!!

MSK

A

Infection of the bone from bacteremia or trauma; most common pathogen is staph A

  • S/S: erythema, edema, tenderness, limp/refusal to bear weight or use extremity fever, chills, vomiting

Tx: IV abx, surgery

93
Q

Slipped Capital Femoral Epiphysis (SCFE)

KNOW THIS!!!!!

MSK

A

Head of femur separates from epiphysis & slips backwards w/ potential or complete dislocation

  • common in teens, males, & obese individuals

Dx: “ice cream slipping off cone” on pelvic x-ray

94
Q

Legg-Calve-Perthes Disease

KNOW THIS!!!!!

MSK

A

Condition where the proximal femoral epiphysis has a temporary interruption in blood supply; leads to bone necrosis; common in males 4-8 years old

Dx: x-ray of pelvis & MRI

S/S: hip pain on affected side, different leg lengths, internal rotation & abduction are limited

95
Q

Parkland Formula

KNOW THIS!!!!!!

Skin

A

Fluids required in first 24 hours

  • 4 mL x body weight (KG) x % surface area burned
96
Q

Tinea Corporis

KNOW THIS!!!!!!

Skin

A

pink, scaly, circular patch w/ raised border & clear center

  • acquired from human, animal, or contaminated objects
97
Q

Tinea Capitus

KNOW THIS!!!!!!

Skin

A

Ring Worm – scaly pustular bald area; yellow, red, or lighter than skin color, broken hairs look like black dots on the scalp

  • Kerion: purulent, boggy mass on scalp with drainage
98
Q

Scabies

KNOW THIS!!!!!!

Skin

A

Caused by mites

  • treat everyone
99
Q

Rule of Palm

KNOW THIS!!!!!!

Skin

A

Estimating burns using palm of hand
* 1% = size of palm

100
Q

Superficial Burn (1st degree)

KNOW THIS!!!!!!

Skin

A

Burn to the outermost layers of the skin

  • minor to moderate pain; red; heals in few days

SUNBURN

101
Q

Partial Thickness (2nd Degree) Burn

KNOW THIS!!!!!!

Skin

A

Burns epidermis & part of the dermis

  • blistering
  • heals in 10-14 days
102
Q

Full Thickness (3rd degree) Burn

KNOW THIS!!!!!!

Skin

A

Burns all of the epidermis & dermis

  • nerve endings are destroyed; need skin graft

Pediatrics Final Exam (5 decks)

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