Lecture 1 Flashcards
1
Q
what is GER?
A
gastroesophageal reflux
2
Q
is GER chronic or acute?
A
Acute
3
Q
when does GER peak in children?
A
4 months
3
Q
when does GER solve on its on typically?
A
12 months
4
Q
what are the symptoms of GER in children?
A
4
Q
what are the symptoms of GER in infants?
A
Regurgitate resp problem…strider wheeze….back pain…….CHILDREN ABD PAIN
5
Q
who is at risk for GER?
A
infants, asthma, scoliosis, and CF
6
Q
how is GER diagnosed?
A
mainly 24 hour esophageal pH monitoring but can be diagnosed from symptoms
7
Q
what are non pharm treatments of GER in infants?
A
thickened formula to honey/nectar consistency, rice cereal, and sitting up for one hour post feed
8
Q
what ratio of rice cereal helps infants with GER?
A
1 tsp to 1 tbsp per ounce of milk
9
Q
what are non pharm treatments of GER in children?
A
lifestyle mods, weight loss, diet, exercise, sitting up after meals
10
Q
what surgery helps with GER?
A
Nissen fundiplication
11
Q
when should infants be put on medication for GER?
A
if they are loosing weight and have resp complications
12
Q
what meds help with GER?
A
H2s and PPIs
13
Q
how do H2s and PPIs work?
A
by lowering the amount of acid in the stomach
14
Q
how do antacids work?
A
raise the pH of the stomach which lowers acidity
15
Q
what is the ending for PPIs?
A
zole
16
Q
what is the ending for H2s?
A
dines
17
Q
when should you take PPI?
A
30 minutes before a meal
18
Q
does pharm intervention of GER stop it completely?
A
no so be prepared with bibs
19
Q
constant GER leads to what being low?
A
growth and weight
20
Q
why is diarrhea bad for infants?
A
they dehydrate quickly
21
Q
how long does acute diarrhea last?
A
under 14 days
22
Q
how long does chronic diarrhea last?
A
14 days or more
23
what are common causes of acute diarrhea?
infection, stomach bug, salmonella, antibiotics, rotavirus
24
what are common causes of chronic diarrhea?
patient cant absrob, IBS, lactose intolerance, food allergy
25
what is non specific chronic diarrhea?
diarrhea that is not causing problems
26
how is diarrhea spread?
fecal oral, contaminated, person to person
27
what diet is contraindicated in patients with diarrhea?
BRAT
28
what nutrient should diarrhea patietns avoid?
high carbs and high sodium
29
what should you closely monitor for in patients with diarrhea?
dehydration
29
what are signs of dehydration?
Poor skin turgor, High HR, Dry mucosa, Low BP, Sunken fontanels, no tears produced, slow cap refill
30
what stool questions should you ask?
how much, how frequent, what color, consistency, smell, exposure, vomiting, have you traveled, tried new foods etc
31
at what point do you do a stool culture?
after 14 days
32
what type of hydration do severely dehydrated patients need?
IV
33
how much fluid per kg do mildly dehydrated patients need?
50 per kg per 4 hours
34
how much fluid per kg do moderate dehydrated patients need?
100ml per kg per 4 hours
35
what medication should be avoided if you have diarrhea?
anti diarrheals
36
what are symptoms of mild dehydration?
thirst and dry mucus membranse
37
what are symptoms of moderate dehydration?
loss of skin turgor, sunken eyes, sunken fontanel, with mild symptoms too
38
what are symptoms of severe dehydration?
rapid pulse, cyanosis, coma, and other previous symptoms
39
what is the ratio for hydration in IV?
40ml per kg
40
what is Hirschsprung disease?
congenital disease that causes chronic constipation due to colon missing ganglion cells
41
why is missing ganglion cells bad?
because it make food not move through like its supposed to leading to constipation
42
what are the symptoms of Hirschsprung in newborn?
no meconium in 24-48 hours, refusal to feed, abdominal distention, and bilious vomiting
43
what are the symptoms of Hirschsprung in infants?
failure to thrive, abdominal distention, constipation, shock, RIBBON LIKE FOUL SMELLING POOP
44
what can Hirschsprung lead to?
enterocolitis and toxic megacolon
44
what are the symptoms of Hirschsprung in childhood?
failure to thrive, constipation, abdominal distention, RIBBON LIKE FOUL SMELLING POOP
45
what are the symptoms of enterocolitis?
fever, abdominal pain, explosive diarrhea
46
how is Hirschsprung diagnosed?
colonoscopy looking for parts of colon without ganglion cells to biopsy
47
what are the surgical options for hirschsprung?
resection or colostomy
48
what should be done pre op for Hirschsprung?
hydration, nutrients, and stomach measurementw
49
what should be done post op for Hirschsprung?
watch for infection, stool pass, colostomy care, and stoma coloring
50
what is esophageal atresia?
there is a disconnect in the esophagus not allowing food to go down to the stomach
51
what are symptoms of esophageal atresia?
vomitting, refusal to feed, aspiration and drooling
52
what is Tracheoesophageal fistula?
connection between esophagus and trachea
53
what are symptoms of Tracheoesophageal fistula
aspiration, choking, coughing, cyanosis,
54
what is atresia and fistual?
there is no connection to stomach and the upper esophagus connects to the lungs
55
what are symptoms of atresia and fistula?
excessive salivation, coughing, choking, cyanosis
56
how can any of the structural defects be diagnosed?
bronchoscopy
57
how can structural deffects be diagnosed based on mothers amniotic fluid?
if there is an excessive amount of amniotic fluid they know the child cant swallow
58
what is the treatment for structural deffects?
npo, iv fluids, supine/sidelying, prone, suction, surgery
59
what should be done post op for structural deffect?
pain management, NPO, signs of choking
60
what are structural defect patients at risk for post op?
GER and respiratory problems
61
what education is given to parents with a structural defect baby?
small feeds, good feeding positions, watch for regurgitation, choking, cyanosis
62
what is cleft lip?
malformation of the outer mouth
63
what is cleft palate?
malformation of the palate inside the mouth
64
what can cause the clefts?
syndrome, genetic link, environmental, and folate deficiency
65
what foods are high in folate?
dark leafy greens, beans, peanuts, eggs
66
what is the biggest concern for the cleft babies?
failure to thrive
67
when should children have the cleft surgery done ?
usually at 3-4 months but before 12 months
68
what is pre op ed for cleft babies?
different bottles and burp the baby more frequentyl
69
what should be done post cleft surgery?
Protect sutures, elbow restraints, avoid suction, avoid anything in mouth, syringe feeding 7-10 days, PETROLEUM JELLY
70
what are cleft surgery babies at risk for?
otitis media
71
what are hernias?
defect in abdominal wall that protrudes intestines
72
when is a hernia a emergency?
when you push it and it does not go back in
73
is a hard hernia normal?
no
74
what is rectal atresia?
anus present but not connected to colon
75
what is rectal stenosis?
narrowing of the rectum
76
what is cloaca?
bowel and urine emptying into one channel
77
what is imperforate anus
there is no anus
78
how soon do imperforate patients need surgery?
within 24 hours
79
how to diagnose anus/colon problems
visual observation and if the have not pooped in 24 hours
80
what should a stoma look like?
red and full
81
what is hypospadias?
urethra opens up anywhere along penis or taint
82
where is hypospadias most severe?
the lower
83
how long do you wait before hypospadias surgery?
6-12 months
84
when is circumcision done for hypospadias patients done?
post op
85
what med is given post op for hypospadias?
oxybutin
86
what should you know about oxybutin??
???
87
what post op ed for hypospadias?
stent for 5-10 days, oxybutin every 6-8 hours, dont submerge baby, and antibiotics
88
when do you stop taking oxybutin?
when the stent is removed
89
what should you do the diaper post circ?
petroleum jelly
90
what is celiac disease?
the inability to tolerate gluten
91
symptoms of celiac disease?
steatorrhea(fatty), frothy, oily, foul poops, malnourished, anorexia, abd distention
92
what is the treatment for celiac?
avoid gluten
93
what is pyloric stenosis?
pyloric sphincter narrowing
94
what is symptoms for pyloric stenosis?
projectile vomiting, hungry, weight loss, dehydration, olive shapped mass in upper abdomen
95
how is pyloric stenosis diagnosed?
ultrasound or mass palpation
96
what is treatment for pyloric stenosis?
surgery
97
what is normal after pyloric surgery?
vomiting
98
what is intussusception?
bowel telescopes down
99
what are the symptoms of intussusception?
Red jelly-like stool, sudden onset abd pain, knees to chest, palpable sausage shaped mass in upper right quadrant, come in waves
100
where can you palpate intussesception?
sausage shape in upper right
101
what is the diagnosis for intussesception?
ultrasound
102
what is the treatment for intussesception?
air enema, IV, nasogastric decomp, antibiotics, surgery, resection
103
what is appendicits?
inflammation of the appendix
104
what are symptoms of appendicitis?
pain in the umbilicus that reffers to the right lower quadrant, fever, decreased bowel sounds, fever, diarrhea, vomiting,
105
what does it mean if the appendicitis patient suddenly feels better?
that the appendix ruptured
106
what can appendicitis lead to ?
perforation and peritonitis
107
what are symptoms of peritonitis?
fever and rigid stomach
108
what happens when you palpate appendicits?
feels better until let go of
109
what is McBurney point?
palpating the appendix
110
what is treatment for appendicitis?
surgery, npo, antibiotics, fluids
111
what is colic baby?
a baby that continues to cry
112
when is it most common to hear colicy baby?
in the evenining
113
what age does colicy baby stop?
12-16 weeks
114
what is the rule of three for colicy baby?
3 hours a day, more than 3 days a week, for 3 weeks
115
what is a possible cause for colicy?
cows milk
116
what is failure to thrive?
inadequate grow due to inability to obtain cal or use required cals
117
what are some causes of failure to thrive?
inadequate cal, neglect, improper formula pre, poverty, breast feeding problems, bad absorption, increased metabolism, infection
118
how do you diagnose failure to thrive
watching weight and height
119
what is the number that makes a child failure to thrive
5th percentil
120
what do you do for failure to thrive
identify cause, give food they want, junk food, high calorie foods and drinks
121
what should you look out for in failure to thrive when giving food?
refeeding
122
what to keep in mind when getting failure to thrive patients food
calm, avoid distractions, new foods slowly, routine, face to face
123
what is iron deficiency anemia?
occurs when their is a insufficient amount of iron in the diet
124
how is iron deficiency anemia diagnosed?
blood test
125
what is the treatment for iron deficiency anemia?
iron sup, iron fortified foods,
126
what ed should you give to a person taking iron sups?
give with citrus to aid in absorption, give doses in between meals, liquid form can stain teeth brown, can make stool tarry/black
127
how can you prevent iron anemia?
start sup at 4 months if breast fee
128
what is nephrotic syndrome?
outer coating of kidney that supposed to be completely impermeable becomes permeable to certain substances
129
what substances become permeable to kidney in nephrotic syndrome?
albumin and proteins
130
what are the symptoms of nephrotic syndrome?
frothy/foamy/dark urine, facial edema, weight gain, ascites, irritable, susceptible to infections
131
what labs will be altered in nephrotic syndrome?
hyperlipidemia, hypoalbumin, extra protein in urine
132
how to diagnose nephrotic syndrome?
UA will show 2+ protein in urine, labs will have hypoalbumin, and hyperlipid
133
what is the treatment for nephrotic syndrome?
prevent infection, low sodium, fluid restriction, diuretics, steroids
134
what is a common age for nephrotic syndrome?
2-7
135
what are side effects of steroids?
increased appetite, weight gain, hyperglycemia, breaking bones, behavior changes
136
how long are nephrotic syndrome patients on steroids?
12 weeks total 6 weeks regular dose and 6 weeks taper
137
what is included in a neuro assessment?
LOC, Orientation, coma scale, vital signs, skin, eyes, motor function, posturing, reflexed
138
how do you assess LOC in relation to a neuro assessment?
are they responding to you
139
how do you assess orientation in relation to a neuro assessment?
who are you, where are you, what year is it, why are you here
140
how do you assess coma scale in relation to a neuro assessment?
less than 8 is unconcious
141
how do you assess vital signs in relation to a neuro assessment?
depressed RR, Increased temp, pulse, slow/depth of resp, breath smell
142
how do you assess skin in relation to a neuro assessment?
look for trauma or needle marks
143
how do you assess eyes in relation to a neuro assessment?
need to see if they are reactive
144
what does fixed dilated pupils mean?
emergency
145
what is dolls head maneuver?
have them focus on an object and turn their head....if the eyes dont move when the head is moved that bad
146
what is the caloric test?
10ml of ice in the ear eye should move towards ear
147
what is the fundoscopic exam?
looks at the eye for swelling or hemmorhage
148
how do you assess motor functino in relation to a neuro assessment?
looking for symmetry from left to right, gait, and spasms
149
how do you assess posturing in relation to a neuro assessment?
look at their arms
150
what can stimulate someone into posturing?
suction, turning, touch
151
what is decorticate posturing?
hands to chest
152
what is decerbrate posturing?
hands at hips with fingers out
153
what is tonic neck reflex?
when arms and legof the same side extend when head is turned
153
what is moro reflex?
when the child is dropped they spread arms out
154
what is withdrawal reflex?
when pain is intiated the body part moves
155
what is babinski reflex?
sole of foot stroked making the big to go up and the toes fan out
156
when should babinski reflex go away?
after 12 months
157
what causes increased ICP?
tumor, trauma, inflammation, bleeding
158
what are signs of increased ICP in infants?
bulged fontanels, high pitched cry, poor feeding
159
what are signs of increased ICP in children?
headache, vomiting, blurred vision
160
what are late signs of increased ICP?
brady, posturing, increased pupils, coma, decreased LOC, cheyene stokes, pailledema
161
what is papiledema?
smelling of the optic nerve
162
what is Cheyne stokes like
shallow fast breathing with apnea
163
what should you do for unconscious child?
circulation, airway, breathing, stabilize c spine, treat shock reduce iCP
164
do ICP patients need vent?
they could
165
how to stabilize c spine?
keep head midline and at 30 or more
166
how to treat shock?
fluids
167
how to reduce ICP?
limit visitors, dark, calm room, pain meds,
168
what should you never do unless absolutely necessary for ICP patient?
suction
169
what are the VITALS of ICP
cushings triad....bradycardia, widening BP, irregular breathing
170
what will pain do for posturing and ICP?
posturing present and ICP go up
171
what should you know about nutrition for increased ICP patients?
strict I and Os, not as many fluids, g or ng if neccesary
172
how often do you assess patient with increased ICP?
q15
173
what meds could a ICP patient get?
Depends on what is causing the ICP
antibiotics, steroids, diuretics, antiepiletics
174
what happens to thermo regulation in increased ICP patients?
at risk for hyperthermia
175
what to do if increased ICP patient is hyperthermic?
antipyretics and cooling/ice on groin and armpits
176
what do increased ICP patients need for eliminatino?
cath and diaper
177
what hygeine needs to be done for increased ICP?
skin integ, oral care 2x a day, lips, artificial tears
178
what exercise is done for increased ICP?
gentle rom
179
what are the kinds of intracranial pressure monitoring devices?
intraventricular, subarachnoid, epidural sensor, and anterior fontanel
180
what is the best way of measuring ICP?
intraventricular cath
181
what should be monitored for with ICP monitor devices?
infection
182
what is given to patient as last resort for icp
mannitol
183
what is mannitol?
diuretic used to treat ICP
184
is mannitol pushed fast or slow.
generally slow but in emergency fast
185
what is bacterial meningitis?
infection of meninges
186
how bad is bacterial meningitis?
medical emergency
187
what are the symptoms of bacterial meniningits?
abrupt onsent, fever, chills, vomitting, seizures, photophobia, petecha, NUCHAL RIGIDITY
188
what is nuchal rigidity?
a sign on meningitis that is characterized by stick neck that hurts
189
how is meningitis diagnosed?
lumbar puncture and blood culture
190
what is a contraindication for lumbar puncture?
increased ICP
191
what type of infection can cause meningitis?
Bacterial of viral
192
what type of precaution is meningitis
droplet
193
what meds are given to meningitis patients?
antibiotics, antipyretics, antiepileptic
194
what is a seizure?
irregular electrical activity in brain
195
does having a seizure mean you have a seizure disorder?
no
196
what is the amount of seizures for epilepsy
2 seizures at least 24 hours apart
197
what is a partial seizure?
seizure that only happens in part of the brain
198
what is a generalized seizure?
happens in both hemispheres
199
what are symptoms of partial seizure?
200
what are symptoms of a tonic seizure?
eyes roll back, loss of LOC, clonic, arms flexed, neck/head/legs extneded, cyanotic, drool, postical stage
201
what is a absence seizures?
multiple a day, last 10 seconds, loss of LOC, no post ictal state, mistaken for day dreaming
202
what are the symptoms of akinetic seizure
child will fall to floor, momentary loss of LOC, no post ictal phase
203
what are symptoms of myoclonic seizure?
twitching, contractures, ictal stage....cant talk afterwards
204
what are symptoms of infantile seizure
xx
205
what is status epileticus?
seizures are happening frequently and lasting more than 30 minutes
206
what can status epilepticus lead to?
resp failure, exhaustion, death
207
can the child gain consciousness between status epilepticus
no
208
what is the first med given to seizure patient?
lorazepam or diazepam
209
what is the second med given to seizure patients?
phenytoin, fosphenytoin, and phenobarbital
210
is phenytoin pushed fast or slow?
slow with normal saline
211
is fosphenytoin pushed past or slow?
fast can be given with glucose agent / TPN
212
what might have to happen to patient if the seizures cant be stopped?
intubation
213
how are seizures diagnosed
CT, MRI, EEg
214
what is mainly used to diagnose seizures?
EEG
215
what labs are run for seizure patients?
BMP, CBC, Glucose and lead
216
what meds are given to prevent seizures
Phenytoin
Phenobarbital
Levetiracetam
217
what is monotherapy?
the idea that only one seizure med is given at a time
218
how are seizure meds experimneted on with patietn
start on one then taper off when starting another
219
what kind of diet helps seizure patients?
keto diet
220
what can be implanted to help with seizures
vagus nerve stim
221
what surgery is done to help with seizure?
removing the problematic part of the brain
222
what to do during a seizure?
turn them, give lorazepam, oxygen, suction, pad bed
223
what can happen to the tongue during seizure?
it can become hypotnic and block the air way
224
what do you document post seizure?
onset, movements, pallor, cyanosis, resp effort, incontinent, post seizure behavior
225
what patient ed is given to seizure patient?
dont skip dose, side effects of meds, taper off, call if rash is present, keep them in side lying posistion, check mouth, dont leave them
226
what are side effects of benzos aka pams?
drowsy, confused, slurred speach, weakness, memory problems
227
what is the age range that febrile seizures occur?
1month to 5 years
228
what febrile seizures?
seizure caused by a fever
229
what is the most common combination that causes febrile seizures?
under 18 months with a virus
230
when does a febrile seizure need treatment?
after 5 minutes
231
can parents transport febrile seizure patient to the hospital?
no
232
what is the treatment for febrile seizure
benzo, epileptic med, antipyretics dont work?????
233
do febrile seizures call for chronic use of anti seizure meds?
no
234
what is hydrocephalus?
imbalance in the production and absorption of CSF
235
what does hydrocephalus look like?
big head
236
what are symptoms of hydrocephalus in infants?
buldged fontanel, big head, split sutures
237
what are symptoms of hydrocephalus in children
headache that gets better after throwing up or sitting up, can have ataxia/strabismus
237
how is hydrocephalus diagnosed in infants?
head grows 1 or more percent in 2-4 weeks
238
how is hydrocephalus diagnosed in children?
CT or MRI
239
what is the treatment of hydrocephalus
surgery and shunt...shunt deposits CSF into the peritoneal to be excreted
240
what can cause hydrocephalus?
malformation, trauma, infection, spina bifida
241
what are complications of shunt?
kinking of tube, plugging of tubing, movement, need for revision, and infection
242
when are you most at risk after shunt placement?
up to 6 months
243
what happens if infections persist with shunt?
Removal
244
how long are you on antibiotics after shunt placement?
7-10 days
245
after the shunt is removed what is placed?
a EVD that drains the CSF
246
what is the care mangment for infant with a hydrocephalus/shunt?
monitor for increased ICP, measure head daily, palpate fontanels
247
what is the nursing care for child with shunt/hydrocephalus
Monitor for changes in LOC, HA, sleep behaviors, developmental abilities
248
what is the post op shunt care?
position patient on non-operative side of head, keep flat, provide pain management, neuro assessment, monitor s/s infection (high temp, poor feeding, abdominal distention, vomiting, decreased responde, seizures)
249
what patient ed is given after shunt is placed?
teach fam, avoid contact sports, wear helmets, look into developmental programs, supprt
250
what is Myelomeningocele aka?
Spina Bifida
251
what does Myelomeningocele look like on the outside?
protrusion along spine that looks like a cyst
252
what causes Myelomeningocele'
genes, syndromes, drugs, radiation, malnutritions, chemical exposure, diabetes, obestiy, FOLIC ACID
253
what dieases is commonly found with Myelomeningocele
hydrocephalus
254
what is the diagnostics for Myelomeningocele
mri, ultrasound, ct, pre natal
255
what do serum tests during pregnancy look for in realtion to Myelomeningocele
elevated alpha theta protein
256
what are the symptoms of Myelomeningocele
bump on lower back
257
fetal surgery of Myelomeningocele
still in utero, prevents hydrocephalus, improves function, high risk
258
when can operation take place on Myelomeningocele
24-72 hours after birth
259
how soon must the operation for Myelomeningocele be done if it is leaking csf
24 hours
260
what should you post op for Myelomeningocele surgery
prevent infection, cover site with sterile gauze, antibiotcs, prone, avoid POVIDONE IODINE
261
why should you avoid povidone iodine on Myelomeningocele
neurotoxic
262
what orthopneic consideration for Myelomeningocele surgery
begin with bed sore prevention and prevention deformities
263
what genitourinary functions for Myelomeningocele surgery
preserve renal function and want older children to acheive continence
264
how to prevent Myelomeningocele
folic acid
265
what is the amount of folic acid you need per day
0.4 mg
266
what temp route is contraindicated in Myelomeningocele
rectal
267
where should babies be placed post Myelomeningocele surgery?
isolete
268
how often to change dressing for Myelomeningocele surgery?
sterile dressing every 2-4 hours
269
what posistion for babies post Myelomeningocele surgery?
prone
270
what allergy are Myelomeningocele babies at risk for?
latex
271
what age must you be to be diagnosed with a cognitive impairment?
less than 18
272
can you be diagnosed with a cognitive above 18?
no
273
what is sub average IQ in
intellectual disability?
75 or below
274
what are areas of functional impairments?
communication, home life, community, leisure, health, safety, self care, social skills, academics, work, self direction
275
what does communication mean in functional impairment?
how well do they interact with others
276
what does home living mean in functional impairment?
how is their environmentq
277
what does leisure mean in functional impairment?
what do they do for fun
278
what are the factors contributing to cognitive impairment?
genetic, biochem, infection, family, social, environmental, organic,
278
how are cognitive impairments diagnosed?
asq, standardized test, screenings, syndromes at birth
279
what level of cognitive impairment can still go to school?
mild
280
what education should be given to cognitive impairment people?
self care, positive enviornment, play, exercise, means of communication, discipline, socialization, planning for future
281
what the best way to get cognitive impaired people to fix a behavior?
redirection
282
whats the best way to communicate with cognitiveley impaired?
short, simple, concrete, using dolls, dont use figures of speech
283
what is down syndrome called?
Trisomy 21
284
what is risk of down syndrome after 35?
1 in 350
285
what is the risk of down syndrome after 40?
1 in 100
286
what are symptoms of downs?
square head, upward slant eye, flat nasal bridge, protroding tongue, epicanthal folds, excess skin around neck, short hands, stubby digits, hypotnia
287
what is hypotnia
low muscle tone
288
what are downs at risk for?
congenital heart defects, hypothyroidism, leukemia, resp tract infection
289
what is the therapeutic management for downs?
surgery for congenital defects, hearing/vision assessment, thyroid test, life expectancy of 60
290
when is down diagnosed?
usually at birth or during screening
291
can a nurse inform the parent that their child has downs?
no
292
what joint issue do downs have?
hyperextension
293
what muscle issue are downs at risk for?
hypotonic
294
why must downs be swaddled tight?
low muscle tone
295
what nose problems do downs have?
underdevleoped nasal bone
296
what does the underdeveloped nasal bone lead to in down/
stuffy nose, increased risk of resp infections, and trouble breathing when feeding
297
what tongue issues do downs have?
protruding tongue that leads to difficutly feeding
298
299
why are downs at risk for constipation?
decreases muscle tone
300
what are downs at risk for growth wise?
weight...obese
301
what kind of soap for downs?
minimal soap and lotion
302
is autism more common boys or girls?
boys
303
what are symptoms of autism?
deficits in social, communication, and behavior, hand flapping, rocking body, decreases response to their name, verbal and motor delays, GI problems/constipation/diarrhea, self abuse, excel in specific areas,
304
what speaking problems milestones do autism kids have?
no babbling by 12, single words by 16 months, 2 words by 2 years
305
what care management for autism?
routine, seeing what they are good and bad at, private room, low stimuli, encourage care giver, encourage personal belongings, cluster care, oral fixations, communication barriers
306
what are the three things that help with communication for autism?
short, simple, concrete
307
what therapy is good for autism?
ST, OT,PT ABA
308
what is aba therapy
applied behavior therapy....take them with you everywhere
309
what family support for autism?
not their fault, treatment programs, care for their child at home, assist in long term placement when they get older
310
what type of sports for autism?
one on one sports no teams
311
what schools for autism
regular school unless deaf/blind
312
what is done when csf is infected?
the external shunt is placed until the infection goes away
313
what procedures can cause meningitis?
lumbar puncture and shunt
314
what does meningitis do to ICP?
increases it
315
what damage can occur due to meningitis?
hearing and learning disability
316
acute symptomatic seizures
due to being caused by something that occurred recently......trauma, meningitis
317
remote symptomatic seizure
nothing going on currently their is a trauma infection from past
318
what is a cryptogenic seizure?
unknown cause
319
what is a idiopathic seizure
genetic
320
what is an atonic seizure?
cant move certain body parts
321
do you dress spina bifida babies
no
322
page 1000 for early signs of delay
323
what type of temp regulation issues do downs have?
hypothermia
324
what is myopia?
near sided where near objects are clear
325
what is hyperopia
far sided objects are clear
326
what is the treatment for myopia and hyperopia?
glasses
327
what is amblyopia?
lazy eye blurred vision
328
what is the treatment for amblyopia
eye patch
329
what is strabismus?
cross eye
330
what is the treatment for strabismus?
eye patch on strong eye
331
what is the visually acuity test?
not when they cant talk helps find vision problems
332
when is vision tests done?
at 5 and then yearly
333
what is a penetrating eye injury?
when foreign object is in the eye
334
what to do if child has penetrating eye injury?
fox shield to damaged eye and eye patch to good eye and ED
335
what do you not do for a penetrating eye injury?
dont rub, dont remove object,
336
what do you do for chemical eye injury?
irrigate for 20 minutes, go to ED, rest with eyes closed, dark room
337
what do you do for non penetrating object?
dont rub, examine eye, remove object with wet gauze
338
what are symptoms of hearing impairment in baby?
not looking when talked to, not answering name, not looking around with loud noise, weird talking
339
when are hearing screens done?
24 hours after birth, before kindergarten, and yearly
340
what not to do if rice and beans are in the ear
dont irrigate with water
341
what is ottis media?
ear infection
342
what are symptoms of ottis media?
hearing loss, fullness inside, pain, pulling at ear, fever, drainage, refusal to feed, crying when laying, change in behavior
343
what part of ear is effected from ottis media?
inner ear
344
what is commonly associated with ear infections?
sickness
345
how are ear drops instilled into a child 3 and under?
pinnea back and down
346
how are drops instilled into 4 and up?
pinnea back and up
347
how is pain treated for ear infecion?
ibuprofen, lay on effected side, heat/cold pack
348
what exposure should you avoid for ear infectino?
smoke
349
how long can fever stay after starting antibiotics for ottis media?
48 hours
350
how long will dr wait before prescribing antibiotics to ottis media
72
351
what is a tymponoplasty?
tubes that are put behind the ear drug to help ear infection
352
what is a myringotomy
cutting ear drum
353
how long do tubes last in ears?
8-18 months
354
what should you avoid getting in ears after tubss?
submerging in water
355
whats normal after tubes are placed?
drainage that is cloudy, smelly
356
what are the second line meds for seizures
fosphenytoin, phenytoin, phenobarbital
357
what are the long term antiepileptics?
phenytoin, phenobarbital, levitiracetam
358
how long are hypospdias patients have stent?
5-10 days
359
how often do you take oxybutin
6-8 hours
