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Pediatrics-MJ > Final: What I think is most important part 2 > Flashcards

Final: What I think is most important part 2 Flashcards

1
Q

What are some causes of CP?

A
  • Brain injury
  • Maternal chorioamnionitis
  • Extremely LBW
  • LBW (low birth weight)
  • Mutltiple births
  • Placenta didn’t provide developing fetus with enough oxygen and nutrient
  • Kernicterus (high levels of bilirubin in neonatal period)
  • Shaken baby syndrome surivors
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2
Q

What are some long term problems associated with CP?

A
  • Visual and hearing impairment
  • Communication and speech difficulities
  • Seizures
  • Intelectual impairment
  • ADHD
  • Dental caries
  • Drooling
  • Nystagmus
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3
Q

The most common chromosomal abnormality of a generalized syndrome?

A

Down syndrome

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4
Q

97% of all down syndrome are attributable to what?

A

An extra chromosome 21 group

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5
Q

What pregs are more at risk for down syndrome baby?

A

Those over 35

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6
Q

DS: What kind of separation in suture? How is head look?

A

Separated sagittal suture
Enlarged anterior fontanel
Small, rounded head
Flat face profile

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7
Q

DS: What are eyes like?

A

Upward, outward slant

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8
Q

DS: What is nose like?

A

Small nose, depressed nasal bridge (saddle nose)

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9
Q

DS: How are ears?

A

Small with short pinna

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10
Q

DS: How is mouth?

A

High, arched, narrow palate

Protruding tongue

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11
Q

DS: What is chest like?

A

Shortened rib cage

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12
Q

DS: How does abdomen look?

A

Protruded

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13
Q

DS: What are hands like?

A

Broad, short hands and stubby fingers

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14
Q

DS: What are feet like?

A

Wide space between big and second toes

Plantar crease between big and second does

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15
Q

DS: Musculoskeletal signs noted?

A

Hyperflexibility and hyptonia

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16
Q

DS: Increased risk for what cancer?

A

Leukemia

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17
Q

A viral infection in which the virus affects the t-lymphs, causing immune dysfunction, which leads to organ dysfunction and a variety of opportunistic illnesses in a weakened host

A

HIV

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18
Q

What kind of HIV/AIDs infection will we see children with Kaposi sarcoma?

A

Severely symptomatic infection

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19
Q

What is the main therapy for HIV?

A

HAART

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20
Q

What antibiotic do we administer to all infants who are born to infected mothers with HIV?

A

Give TMZ-SMZ until HIV infection is excluded

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21
Q

Why would IV gamma globulin be given to HIV pts?

A

To prevent recurrent or serious bacterial infections

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22
Q

What are priority nursing problems for child with HIV?

A
  1. Infection (hand-washing, deep breathing/coughing, and needing to get PCV and flu vaccine)
  2. Education: They cannot miss a dose of their med!! and it needs to be taken on regular schedule!! Adolescents need to under stand high risk sexual behaviors can infect others!!!
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23
Q

What bacteria can cause UTI?

A

E. coli (just an example, there are others)

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24
Q

What does urinalysis look like for UTI?

A

pH: weak acid or neutral alkaline

Protein, glucose, ketones, leukocytes, and nitrates: ALL POSITIVE in urine

Note: Normal urine should be NEGATIVE for protein!!

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25
Q

UTI infants: Feeding like? How do they take it?

A

Poor feeding
Vomiting
Failure to gain weight

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26
Q

UTI infants: Increase or decrease in thirst?

A

Increase

27
Q

UTI infants: Infrequent or frequent urination?

A

Frequent–staining with urination and foul smelling

28
Q 
UTI infants:
Fever?
Diaper rash?
Blood in urine?
Swelling of face, edema?
Seizure, pallor?
Dehydration?
A

Infants:

Fever: yes
Diaper rash: yes
Blood in urine: No (this is in children though!)
Swelling of face, edema: No (this is in children though)
Seizure, pallor: yes
Dehydration: Yes

29
Q

UTI children: How is appetite?

A

Poor–vomiting

30
Q

UTI children: How is growth?

A

Slowed

31
Q

UTI children: Increase or decrease in thirst?

A

Increase–eneuresis; frequent urination

32
Q

UTI children: Is there swelling anywhere?

A

Yes, face–also edema

33
Q

UTI children: Tired? Hypotension or hypertension?

A

Yes fatigued, hypertension; also have tetany

34
Q

UTI children: What kind of urine

Foul smelling or blood in urine?

A

Blood in urine

35
Q

What are some antibiotics given for UTI?

A

Penicillins
Sulfonamide
Cephs
Nitrourantoin

36
Q

What kind of underwear for UTI: cotton or nylon?

A

Suggest use of cotton

37
Q

What should we instruct sexually active adolescents to do to prevent UTI?

A

Instruct them to void immediately after intercourse

38
Q

Nephrotic Syndrome (NS): What is urinalysis like? (4)

A
  • Elevated protein in urine (2+ on dipstick)
  • Hyaline casts
  • FEW RBC
  • Oval fat bodies
39
Q

NS: What is chemistry like? (8)

A
  • Hypoalbuminism: less than 2 g/dl
  • Elevated Hgb, Hct
  • Elevated platelets: 500,000-1,000,000
  • Possible hyponatremia
  • Decreased serum protein level (6.1-7.9)
  • Hyperlipidemia
  • Serum cholesterol: (450-1500 mg/dl)
  • Normal potassium
40
Q

The most common presentation of glomerular injury in children

A

Nephrotic syndrome

41
Q

In nephrotic syndrome, alterations in the glomerular membrane allow proteins, especially _____, to pass into the urine; resulting in decreased serum osmotic pressure

A

Albumin

42
Q

What is most common form of NS?

A

MCNS

43
Q

If a patient with NS has edema, what should we do?

A

RESTRICT SALT

44
Q

A non-specific upper resp. tract infection that manifestations by 4-8 days but is considered to be a precipitation factor rather than a cause of NS

A

Minimal change nephrotic syndreom (MCNS)

45
Q

What are some clinical manifestations of MCNS?

A

-Gain weight over a period of days or weeks
-Puffiness of face (especially around eyes) [this is apparent on arising in am but subsides during day–>then swelling of abdomen and lower exremtieis is more prominent]
-Diarrhea
-Loss of appetite
-Lethargic
Decreased urine volume–dark, opalescent and frothy
-BP NORMAL OR SLIGHTLY DECREASED

46
Q

MCNS: An acute infection may precipitate severe generalized edema..Where?

A

Periorbital edema
Abdominal swelling from ascites
Labial or scrotal swelling

47
Q

What is DOC for MCNS/NS? Client education?

A

Prednisone

-Administer with meals

48
Q

Why would we give diuretics for MCNS/NS? Client education?

A

Eliminates excess fluid from body

-Encourage child to eat foods high in K

49
Q

Why would we give 25% albumin to MCNS/NS pts?

A

To increase plasma volume and decrease edema

50
Q

What drug is given for MCNS/NS for children with frequent relapsing of MCNS or steroid resistant NS?

A

Cyclophosphamide or chlorambucil

51
Q

How does urine look for glomerulonephritis?

A

Smoky or tea colored urine

52
Q

Glomerulonephritis: What test can show presence of streptococcal antibodies?

A

Elevated ASO titer

53
Q

The glomeruli are inflamed, which impaired the kidney to filter urine properly

A

Acute glomerulonephritis (AGN)

54
Q

What VS change is anticipated with glomerulonephritis?

A

Increased BP–HTN

Can give loop diuretics and anti-HTN drugs to help with this

*if not treated, seizures can occur

55
Q

Glomerulonephritis: What are signs of renal failure?

A
  1. Decreased urine output-first sign
  2. HTN encephalopathy
  3. Cardiac decompensation
56
Q 
Glomerulonephritis: 
How is urine?
Increased or decreased blood protein level?
Low, normal, or elevated lipid level?
Increased or decreased K level?
A

Urine: smoky, tea color (also hematuria and proteinuria)

INCREASED blood protein level

NORMAL lipid level

INCREASED K level

57
Q

Since glomerulonephritis can have an increased K level, what foods should be avoided?

A 
Bran cereal
Potatoes 
Tomatoes
Bananas
Melons
Orange 
OJ
Yogurt
Leafy greens
Beans
Avacodos
58
Q

Inappropriate urination that must occur at least 2weeks for at least 3 months–the child must be at least 5 years of age before there is consideration about diagnosis

A

Eneuresis

59
Q

What does DDAVP do?

A

An antidiuretic hormone that reduces volume of urine–given for enuresis

*Can be given PO or nasal, if nasal–store in fridge

60
Q

Why would we give a child with enuresis a TCA?

A

We could give imipramine hydrochloride to INHIBIT urination. We need to make sure to monitor child for increase suicidality though

This is for 6-8 weeks, with a gradual withdrawal

Administer with food and 1 hr before bedtime

Avoid sun exposure and OTC meds while on drug

61
Q

What anticholinergic could we give to child with enuresis?

A

Oxybutin chloride to reduce bladder contractions

62
Q

Meatus opening located on the dorsal surface of the penis

A

Epispadias

Male: widened pubic symphysis, broad/spade like penis
Female: Wide urethra, bifid clitoris

Both: possible exstrophy of bladder

63
Q

Urethral opening located behind glans of penis or on the ventral surface of penile shaft

A

Hypospadias

64
Q

Narrowing of the preputial opening of the foreskin

A

Phimosis

Pediatrics-MJ (61 decks)

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