Kaplan Peds A

Question 1

Fluid replacement amounts for dehydration in peds?

Answer 1

Fluid given rapidly for 3-6h then slowed to maintenance rate. Replacement:

• *<5% loss in body weight 50 mL/kg.
• *10% loss bw 100mL/kg.
• *12-15% loss bw 125 mL/kg.

Question 2

Tmnt for MILD vomit and diarrhea?

Answer 2

Withhold food for 3h/vomit or 1h/diarrhea.
Introduce clear fluid or Pedialyte slowlyl 1 tsp Q15min for 2h; then 1 oz Q2h for the next 12-18 h.
Progress to breast milk

Question 3

Tmnt for prolonged vomit or severe diarrhea?

Answer 3

IV therapy

Question 4

S/Sx dehyd in infant?

Answer 4

Poor skin turgor
Dry skin
Decreased UO
Irritability or lethargy
Depressed fontanells
Sunken eyes

Question 5

What is Tonsilitis?

Answer 5

Inflammation of the lymphatic tissue of the pharynx.
Causes hypoxia and sleep apnea.
Relieves peritonsillar abscesses and recurrent otitis media

Question 6

Tx for tonsilitis?

Answer 6

10 day AB
liquid/soft diet ice chips, popsicles, no ice cream or juice progress to mashed potatoe;
cool vaporizer.
Postop tonsillectomy (perfomed with out sutures by ligation of laser):
Place on stomach with a pillow under chest to encourage mouth drainage;
If bleeding elevate head and position on side
discourage cough;
ice collar;
analgesics;
suction at bedside; offer clear liquid diet;
check throat for bleeding;
Post discharge:
Avoid spicy food;
avoid gargling;
Avoid vigorous brushing;
Avoid activity 7-10 days

Question 7

School age growth and development markers

Answer 7

Ages 6-10
6:
Avg height 45"
loses 1st upper tooth
6y molars erupt
appetitite increases
....

Question 8

Example and mechanism of Cardiac Glycoside?

Answer 8

Digoxin

Decreases heart rate Increases force of contraction

Question 9

SE of Digoxin

Answer 9

bradycardia
anorexia
N&V
fatigue
dysrhythmia
diaphoreis
  Signs of toxicity:
  abdominal pain
  arhythmias
  anorexia
  NV&D
  confusion
  visual disturbance

Question 10

Digoxin toxicity characteristics?

Answer 10

Furosemide
A diuretic causes hypokalemia; K LEVEL .
Take apical pulse for 1 full minute NOTIFY PROVIDER IF RATE FALLS <60; INFANTS HOLD DOSE IF <90-110/MIN

Question 11

Most common HA in children and adults

Answer 11

Tension HA
Dull steady pain
Eyestrain
Tender spots on the head/neck
Tighness in hatband posiiton;
Tx:
analgesics (acetaminophen/tylenol)
sleep
cool compress

Question 12

Headache sign that requires an IMMEDIATE FOLLOW UP?

Answer 12

HA that awakens child @ NIGHT; EARLY AM HA; HA THAT WORSENS WHEN CHILD GETS OO BED IN THE AM; increased frequency & severity; Change in behav/personality

Question 13

Duchenne Muscular Dystrophy properties

Answer 13

Genetic: Recesive genetic defect on X chromosome (women carry and transmit to sons)
PROGRESSIVE muscle fiber degeneration & muscular weakness seen at 2-3 years; Muscle HYPERTROPHY;
Atrophy of voluntary muscles (larger and weaker muscles), mild/moderate mental impairment.
Waddling gait, frequent resp infections and cough bc of weak resp muscles;
Gowers sign: Use of upper body to move from prone to upright)
Result in:
CARDIOMYOPATHY
inability to ambulate by 11-12 yrs
Resp insufficiency
Early death

Question 14

Osteogenesis imperfecta characterisitcs?

Answer 14

Most common osteoporosis syndrom in children; Inherited syndrome causes fractures and bone deformities;
Support when turning, posiitoning etc
S SX
Fracutres
Blue sclera
limb/dental deformities
Progressive hearing loss;
Short limbs, triangular face

Question 15

S/Sx of Strabismus

Answer 15

One or more eye turned out (EXOTROPIA), in (ESOTROPIA), or up (HYPERTROPIA)
Unable to focus on one object;
Closes one eye to look around the room; squinting, tilt head, HA, dizziness, cross eye, error in picking up objects.
Tmnt includes eyepatch on stronger eye, surgery,

Question 16

Congenital heart defects: VSD

Answer 16

Acyanotic defects: VSD ventricular septal defect (abnormal opening between the ventricles which allows blood to flow from high pressured L into lower pressured R side causing an increased blood volume in the R ventricle and lungs);