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PEDS Exam 3 > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

what is GER?

A

gastroesophageal reflux

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2
Q

is GER chronic or acute?

A

Acute

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3
Q

when does GER peak in children?

A

4 months

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3
Q

when does GER solve on its on typically?

A

12 months

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4
Q

what are the symptoms of GER in children?

A
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4
Q

what are the symptoms of GER in infants?

A

Regurgitate resp problem…strider wheeze….back pain…….CHILDREN ABD PAIN

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5
Q

who is at risk for GER?

A

infants, asthma, scoliosis, and CF

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6
Q

how is GER diagnosed?

A

mainly 24 hour esophageal pH monitoring but can be diagnosed from symptoms

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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

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8
Q

what ratio of rice cereal helps infants with GER?

A

1 tsp to 1 tbsp per ounce of milk

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9
Q

what are non pharm treatments of GER in children?

A

lifestyle mods, weight loss, diet, exercise, sitting up after meals

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10
Q

what surgery helps with GER?

A

Nissen fundiplication

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11
Q

when should infants be put on medication for GER?

A

if they are loosing weight and have resp complications

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12
Q

what meds help with GER?

A

H2s and PPIs

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13
Q

how do H2s and PPIs work?

A

by lowering the amount of acid in the stomach

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14
Q

how do antacids work?

A

raise the pH of the stomach which lowers acidity

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15
Q

what is the ending for PPIs?

A

zole

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16
Q

what is the ending for H2s?

A

dines

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17
Q

when should you take PPI?

A

30 minutes before a meal

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18
Q

does pharm intervention of GER stop it completely?

A

no so be prepared with bibs

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19
Q

constant GER leads to what being low?

A

growth and weight

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20
Q

why is diarrhea bad for infants?

A

they dehydrate quickly

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21
Q

how long does acute diarrhea last?

A

under 14 days

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22
Q

how long does chronic diarrhea last?

A

14 days or more

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23
Q

what are common causes of acute diarrhea?

A

infection, stomach bug, salmonella, antibiotics, rotavirus

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24
Q

what are common causes of chronic diarrhea?

A

patient cant absrob, IBS, lactose intolerance, food allergy

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25
Q

what is non specific chronic diarrhea?

A

diarrhea that is not causing problems

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26
Q

how is diarrhea spread?

A

fecal oral, contaminated, person to person

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27
Q

what diet is contraindicated in patients with diarrhea?

A

BRAT

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28
Q

what nutrient should diarrhea patietns avoid?

A

high carbs and high sodium

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29
Q

what should you closely monitor for in patients with diarrhea?

A

dehydration

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29
Q

what are signs of dehydration?

A

Poor skin turgor, High HR, Dry mucosa, Low BP, Sunken fontanels, no tears produced, slow cap refill

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30
Q

what stool questions should you ask?

A

how much, how frequent, what color, consistency, smell, exposure, vomiting, have you traveled, tried new foods etc

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31
Q

at what point do you do a stool culture?

A

after 14 days

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32
Q

what type of hydration do severely dehydrated patients need?

A

IV

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33
Q

how much fluid per kg do mildly dehydrated patients need?

A

50 per kg per 4 hours

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34
Q

how much fluid per kg do moderate dehydrated patients need?

A

100ml per kg per 4 hours

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35
Q

what medication should be avoided if you have diarrhea?

A

anti diarrheals

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36
Q

what are symptoms of mild dehydration?

A

thirst and dry mucus membranse

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37
Q

what are symptoms of moderate dehydration?

A

loss of skin turgor, sunken eyes, sunken fontanel, with mild symptoms too

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38
Q

what are symptoms of severe dehydration?

A

rapid pulse, cyanosis, coma, and other previous symptoms

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39
Q

what is the ratio for hydration in IV?

A

40ml per kg

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40
Q

what is Hirschsprung disease?

A

congenital disease that causes chronic constipation due to colon missing ganglion cells

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41
Q

why is missing ganglion cells bad?

A

because it make food not move through like its supposed to leading to constipation

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42
Q

what are the symptoms of Hirschsprung in newborn?

A

no meconium in 24-48 hours, refusal to feed, abdominal distention, and bilious vomiting

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43
Q

what are the symptoms of Hirschsprung in infants?

A

failure to thrive, abdominal distention, constipation, shock, RIBBON LIKE FOUL SMELLING POOP

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44
Q

what can Hirschsprung lead to?

A

enterocolitis and toxic megacolon

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44
Q

what are the symptoms of Hirschsprung in childhood?

A

failure to thrive, constipation, abdominal distention, RIBBON LIKE FOUL SMELLING POOP

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45
Q

what are the symptoms of enterocolitis?

A

fever, abdominal pain, explosive diarrhea

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46
Q

how is Hirschsprung diagnosed?

A

colonoscopy looking for parts of colon without ganglion cells to biopsy

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47
Q

what are the surgical options for hirschsprung?

A

resection or colostomy

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48
Q

what should be done pre op for Hirschsprung?

A

hydration, nutrients, and stomach measurementw

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49
Q

what should be done post op for Hirschsprung?

A

watch for infection, stool pass, colostomy care, and stoma coloring

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50
Q

what is esophageal atresia?

A

there is a disconnect in the esophagus not allowing food to go down to the stomach

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51
Q

what are symptoms of esophageal atresia?

A

vomitting, refusal to feed, aspiration and drooling

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52
Q

what is Tracheoesophageal fistula?

A

connection between esophagus and trachea

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53
Q

what are symptoms of Tracheoesophageal fistula

A

aspiration, choking, coughing, cyanosis,

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54
Q

what is atresia and fistual?

A

there is no connection to stomach and the upper esophagus connects to the lungs

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55
Q

what are symptoms of atresia and fistula?

A

excessive salivation, coughing, choking, cyanosis

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56
Q

how can any of the structural defects be diagnosed?

A

bronchoscopy

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57
Q

how can structural deffects be diagnosed based on mothers amniotic fluid?

A

if there is an excessive amount of amniotic fluid they know the child cant swallow

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58
Q

what is the treatment for structural deffects?

A

npo, iv fluids, supine/sidelying, prone, suction, surgery

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59
Q

what should be done post op for structural deffect?

A

pain management, NPO, signs of choking

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60
Q

what are structural defect patients at risk for post op?

A

GER and respiratory problems

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61
Q

what education is given to parents with a structural defect baby?

A

small feeds, good feeding positions, watch for regurgitation, choking, cyanosis

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62
Q

what is cleft lip?

A

malformation of the outer mouth

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63
Q

what is cleft palate?

A

malformation of the palate inside the mouth

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64
Q

what can cause the clefts?

A

syndrome, genetic link, environmental, and folate deficiency

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65
Q

what foods are high in folate?

A

dark leafy greens, beans, peanuts, eggs

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66
Q

what is the biggest concern for the cleft babies?

A

failure to thrive

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67
Q

when should children have the cleft surgery done ?

A

usually at 3-4 months but before 12 months

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68
Q

what is pre op ed for cleft babies?

A

different bottles and burp the baby more frequentyl

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69
Q

what should be done post cleft surgery?

A

Protect sutures, elbow restraints, avoid suction, avoid anything in mouth, syringe feeding 7-10 days, PETROLEUM JELLY

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70
Q

what are cleft surgery babies at risk for?

A

otitis media

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71
Q

what are hernias?

A

defect in abdominal wall that protrudes intestines

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72
Q

when is a hernia a emergency?

A

when you push it and it does not go back in

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73
Q

is a hard hernia normal?

A

no

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74
Q

what is rectal atresia?

A

anus present but not connected to colon

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75
Q

what is rectal stenosis?

A

narrowing of the rectum

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76
Q

what is cloaca?

A

bowel and urine emptying into one channel

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77
Q

what is imperforate anus

A

there is no anus

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78
Q

how soon do imperforate patients need surgery?

A

within 24 hours

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79
Q

how to diagnose anus/colon problems

A

visual observation and if the have not pooped in 24 hours

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80
Q

what should a stoma look like?

A

red and full

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81
Q

what is hypospadias?

A

urethra opens up anywhere along penis or taint

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82
Q

where is hypospadias most severe?

A

the lower

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83
Q

how long do you wait before hypospadias surgery?

A

6-12 months

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84
Q

when is circumcision done for hypospadias patients done?

A

post op

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85
Q

what med is given post op for hypospadias?

A

oxybutin

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86
Q

what should you know about oxybutin??

A

???

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87
Q

what post op ed for hypospadias?

A

stent for 5-10 days, oxybutin every 6-8 hours, dont submerge baby, and antibiotics

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88
Q

when do you stop taking oxybutin?

A

when the stent is removed

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89
Q

what should you do the diaper post circ?

A

petroleum jelly

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90
Q

what is celiac disease?

A

the inability to tolerate gluten

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91
Q

symptoms of celiac disease?

A

steatorrhea(fatty), frothy, oily, foul poops, malnourished, anorexia, abd distention

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92
Q

what is the treatment for celiac?

A

avoid gluten

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93
Q

what is pyloric stenosis?

A

pyloric sphincter narrowing

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94
Q

what is symptoms for pyloric stenosis?

A

projectile vomiting, hungry, weight loss, dehydration, olive shapped mass in upper abdomen

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95
Q

how is pyloric stenosis diagnosed?

A

ultrasound or mass palpation

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96
Q

what is treatment for pyloric stenosis?

A

surgery

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97
Q

what is normal after pyloric surgery?

A

vomiting

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98
Q

what is intussusception?

A

bowel telescopes down

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99
Q

what are the symptoms of intussusception?

A

Red jelly-like stool, sudden onset abd pain, knees to chest, palpable sausage shaped mass in upper right quadrant, come in waves

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100
Q

where can you palpate intussesception?

A

sausage shape in upper right

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101
Q

what is the diagnosis for intussesception?

A

ultrasound

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102
Q

what is the treatment for intussesception?

A

air enema, IV, nasogastric decomp, antibiotics, surgery, resection

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103
Q

what is appendicits?

A

inflammation of the appendix

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104
Q

what are symptoms of appendicitis?

A

pain in the umbilicus that reffers to the right lower quadrant, fever, decreased bowel sounds, fever, diarrhea, vomiting,

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105
Q

what does it mean if the appendicitis patient suddenly feels better?

A

that the appendix ruptured

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106
Q

what can appendicitis lead to ?

A

perforation and peritonitis

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107
Q

what are symptoms of peritonitis?

A

fever and rigid stomach

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108
Q

what happens when you palpate appendicits?

A

feels better until let go of

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109
Q

what is McBurney point?

A

palpating the appendix

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110
Q

what is treatment for appendicitis?

A

surgery, npo, antibiotics, fluids

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111
Q

what is colic baby?

A

a baby that continues to cry

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112
Q

when is it most common to hear colicy baby?

A

in the evenining

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113
Q

what age does colicy baby stop?

A

12-16 weeks

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114
Q

what is the rule of three for colicy baby?

A

3 hours a day, more than 3 days a week, for 3 weeks

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115
Q

what is a possible cause for colicy?

A

cows milk

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116
Q

what is failure to thrive?

A

inadequate grow due to inability to obtain cal or use required cals

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117
Q

what are some causes of failure to thrive?

A

inadequate cal, neglect, improper formula pre, poverty, breast feeding problems, bad absorption, increased metabolism, infection

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118
Q

how do you diagnose failure to thrive

A

watching weight and height

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119
Q

what is the number that makes a child failure to thrive

A

5th percentil

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120
Q

what do you do for failure to thrive

A

identify cause, give food they want, junk food, high calorie foods and drinks

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121
Q

what should you look out for in failure to thrive when giving food?

A

refeeding

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122
Q

what to keep in mind when getting failure to thrive patients food

A

calm, avoid distractions, new foods slowly, routine, face to face

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123
Q

what is iron deficiency anemia?

A

occurs when their is a insufficient amount of iron in the diet

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124
Q

how is iron deficiency anemia diagnosed?

A

blood test

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125
Q

what is the treatment for iron deficiency anemia?

A

iron sup, iron fortified foods,

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126
Q

what ed should you give to a person taking iron sups?

A

give with citrus to aid in absorption, give doses in between meals, liquid form can stain teeth brown, can make stool tarry/black

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127
Q

how can you prevent iron anemia?

A

start sup at 4 months if breast fee

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128
Q

what is nephrotic syndrome?

A

outer coating of kidney that supposed to be completely impermeable becomes permeable to certain substances

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129
Q

what substances become permeable to kidney in nephrotic syndrome?

A

albumin and proteins

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130
Q

what are the symptoms of nephrotic syndrome?

A

frothy/foamy/dark urine, facial edema, weight gain, ascites, irritable, susceptible to infections

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131
Q

what labs will be altered in nephrotic syndrome?

A

hyperlipidemia, hypoalbumin, extra protein in urine

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132
Q

how to diagnose nephrotic syndrome?

A

UA will show 2+ protein in urine, labs will have hypoalbumin, and hyperlipid

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133
Q

what is the treatment for nephrotic syndrome?

A

prevent infection, low sodium, fluid restriction, diuretics, steroids

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134
Q

what is a common age for nephrotic syndrome?

A

2-7

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135
Q

what are side effects of steroids?

A

increased appetite, weight gain, hyperglycemia, breaking bones, behavior changes

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136
Q

how long are nephrotic syndrome patients on steroids?

A

12 weeks total 6 weeks regular dose and 6 weeks taper

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137
Q

what is included in a neuro assessment?

A

LOC, Orientation, coma scale, vital signs, skin, eyes, motor function, posturing, reflexed

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138
Q

how do you assess LOC in relation to a neuro assessment?

A

are they responding to you

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139
Q

how do you assess orientation in relation to a neuro assessment?

A

who are you, where are you, what year is it, why are you here

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140
Q

how do you assess coma scale in relation to a neuro assessment?

A

less than 8 is unconcious

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141
Q

how do you assess vital signs in relation to a neuro assessment?

A

depressed RR, Increased temp, pulse, slow/depth of resp, breath smell

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142
Q

how do you assess skin in relation to a neuro assessment?

A

look for trauma or needle marks

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143
Q

how do you assess eyes in relation to a neuro assessment?

A

need to see if they are reactive

144
Q

what does fixed dilated pupils mean?

A

emergency

145
Q

what is dolls head maneuver?

A

have them focus on an object and turn their head….if the eyes dont move when the head is moved that bad

146
Q

what is the caloric test?

A

10ml of ice in the ear eye should move towards ear

147
Q

what is the fundoscopic exam?

A

looks at the eye for swelling or hemmorhage

148
Q

how do you assess motor functino in relation to a neuro assessment?

A

looking for symmetry from left to right, gait, and spasms

149
Q

how do you assess posturing in relation to a neuro assessment?

A

look at their arms

150
Q

what can stimulate someone into posturing?

A

suction, turning, touch

151
Q

what is decorticate posturing?

A

hands to chest

152
Q

what is decerbrate posturing?

A

hands at hips with fingers out

153
Q

what is tonic neck reflex?

A

when arms and legof the same side extend when head is turned

153
Q

what is moro reflex?

A

when the child is dropped they spread arms out

154
Q

what is withdrawal reflex?

A

when pain is intiated the body part moves

155
Q

what is babinski reflex?

A

sole of foot stroked making the big to go up and the toes fan out

156
Q

when should babinski reflex go away?

A

after 12 months

157
Q

what causes increased ICP?

A

tumor, trauma, inflammation, bleeding

158
Q

what are signs of increased ICP in infants?

A

bulged fontanels, high pitched cry, poor feeding

159
Q

what are signs of increased ICP in children?

A

headache, vomiting, blurred vision

160
Q

what are late signs of increased ICP?

A

brady, posturing, increased pupils, coma, decreased LOC, cheyene stokes, pailledema

161
Q

what is papiledema?

A

smelling of the optic nerve

162
Q

what is Cheyne stokes like

A

shallow fast breathing with apnea

163
Q

what should you do for unconscious child?

A

circulation, airway, breathing, stabilize c spine, treat shock reduce iCP

164
Q

do ICP patients need vent?

A

they could

165
Q

how to stabilize c spine?

A

keep head midline and at 30 or more

166
Q

how to treat shock?

A

fluids

167
Q

how to reduce ICP?

A

limit visitors, dark, calm room, pain meds,

168
Q

what should you never do unless absolutely necessary for ICP patient?

A

suction

169
Q

what are the VITALS of ICP

A

cushings triad….bradycardia, widening BP, irregular breathing

170
Q

what will pain do for posturing and ICP?

A

posturing present and ICP go up

171
Q

what should you know about nutrition for increased ICP patients?

A

strict I and Os, not as many fluids, g or ng if neccesary

172
Q

how often do you assess patient with increased ICP?

A

q15

173
Q

what meds could a ICP patient get?

A

Depends on what is causing the ICP

antibiotics, steroids, diuretics, antiepiletics

174
Q

what happens to thermo regulation in increased ICP patients?

A

at risk for hyperthermia

175
Q

what to do if increased ICP patient is hyperthermic?

A

antipyretics and cooling/ice on groin and armpits

176
Q

what do increased ICP patients need for eliminatino?

A

cath and diaper

177
Q

what hygeine needs to be done for increased ICP?

A

skin integ, oral care 2x a day, lips, artificial tears

178
Q

what exercise is done for increased ICP?

A

gentle rom

179
Q

what are the kinds of intracranial pressure monitoring devices?

A

intraventricular, subarachnoid, epidural sensor, and anterior fontanel

180
Q

what is the best way of measuring ICP?

A

intraventricular cath

181
Q

what should be monitored for with ICP monitor devices?

A

infection

182
Q

what is given to patient as last resort for icp

A

mannitol

183
Q

what is mannitol?

A

diuretic used to treat ICP

184
Q

is mannitol pushed fast or slow.

A

generally slow but in emergency fast

185
Q

what is bacterial meningitis?

A

infection of meninges

186
Q

how bad is bacterial meningitis?

A

medical emergency

187
Q

what are the symptoms of bacterial meniningits?

A

abrupt onsent, fever, chills, vomitting, seizures, photophobia, petecha, NUCHAL RIGIDITY

188
Q

what is nuchal rigidity?

A

a sign on meningitis that is characterized by stick neck that hurts

189
Q

how is meningitis diagnosed?

A

lumbar puncture and blood culture

190
Q

what is a contraindication for lumbar puncture?

A

increased ICP

191
Q

what type of infection can cause meningitis?

A

Bacterial of viral

192
Q

what type of precaution is meningitis

A

droplet

193
Q

what meds are given to meningitis patients?

A

antibiotics, antipyretics, antiepileptic

194
Q

what is a seizure?

A

irregular electrical activity in brain

195
Q

does having a seizure mean you have a seizure disorder?

A

no

196
Q

what is the amount of seizures for epilepsy

A

2 seizures at least 24 hours apart

197
Q

what is a partial seizure?

A

seizure that only happens in part of the brain

198
Q

what is a generalized seizure?

A

happens in both hemispheres

199
Q

what are symptoms of partial seizure?

A
200
Q

what are symptoms of a tonic seizure?

A

eyes roll back, loss of LOC, clonic, arms flexed, neck/head/legs extneded, cyanotic, drool, postical stage

201
Q

what is a absence seizures?

A

multiple a day, last 10 seconds, loss of LOC, no post ictal state, mistaken for day dreaming

202
Q

what are the symptoms of akinetic seizure

A

child will fall to floor, momentary loss of LOC, no post ictal phase

203
Q

what are symptoms of myoclonic seizure?

A

twitching, contractures, ictal stage….cant talk afterwards

204
Q

what are symptoms of infantile seizure

A

xx

205
Q

what is status epileticus?

A

seizures are happening frequently and lasting more than 30 minutes

206
Q

what can status epilepticus lead to?

A

resp failure, exhaustion, death

207
Q

can the child gain consciousness between status epilepticus

A

no

208
Q

what is the first med given to seizure patient?

A

lorazepam or diazepam

209
Q

what is the second med given to seizure patients?

A

phenytoin, fosphenytoin, and phenobarbital

210
Q

is phenytoin pushed fast or slow?

A

slow with normal saline

211
Q

is fosphenytoin pushed past or slow?

A

fast can be given with glucose agent / TPN

212
Q

what might have to happen to patient if the seizures cant be stopped?

A

intubation

213
Q

how are seizures diagnosed

A

CT, MRI, EEg

214
Q

what is mainly used to diagnose seizures?

A

EEG

215
Q

what labs are run for seizure patients?

A

BMP, CBC, Glucose and lead

216
Q

what meds are given to prevent seizures

A

Phenytoin
Phenobarbital
Levetiracetam

217
Q

what is monotherapy?

A

the idea that only one seizure med is given at a time

218
Q

how are seizure meds experimneted on with patietn

A

start on one then taper off when starting another

219
Q

what kind of diet helps seizure patients?

A

keto diet

220
Q

what can be implanted to help with seizures

A

vagus nerve stim

221
Q

what surgery is done to help with seizure?

A

removing the problematic part of the brain

222
Q

what to do during a seizure?

A

turn them, give lorazepam, oxygen, suction, pad bed

223
Q

what can happen to the tongue during seizure?

A

it can become hypotnic and block the air way

224
Q

what do you document post seizure?

A

onset, movements, pallor, cyanosis, resp effort, incontinent, post seizure behavior

225
Q

what patient ed is given to seizure patient?

A

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
Q

what are side effects of benzos aka pams?

A

drowsy, confused, slurred speach, weakness, memory problems

227
Q

what is the age range that febrile seizures occur?

A

1month to 5 years

228
Q

what febrile seizures?

A

seizure caused by a fever

229
Q

what is the most common combination that causes febrile seizures?

A

under 18 months with a virus

230
Q

when does a febrile seizure need treatment?

A

after 5 minutes

231
Q

can parents transport febrile seizure patient to the hospital?

A

no

232
Q

what is the treatment for febrile seizure

A

benzo, epileptic med, antipyretics dont work?????

233
Q

do febrile seizures call for chronic use of anti seizure meds?

A

no

234
Q

what is hydrocephalus?

A

imbalance in the production and absorption of CSF

235
Q

what does hydrocephalus look like?

A

big head

236
Q

what are symptoms of hydrocephalus in infants?

A

buldged fontanel, big head, split sutures

237
Q

what are symptoms of hydrocephalus in children

A

headache that gets better after throwing up or sitting up, can have ataxia/strabismus

237
Q

how is hydrocephalus diagnosed in infants?

A

head grows 1 or more percent in 2-4 weeks

238
Q

how is hydrocephalus diagnosed in children?

A

CT or MRI

239
Q

what is the treatment of hydrocephalus

A

surgery and shunt…shunt deposits CSF into the peritoneal to be excreted

240
Q

what can cause hydrocephalus?

A

malformation, trauma, infection, spina bifida

241
Q

what are complications of shunt?

A

kinking of tube, plugging of tubing, movement, need for revision, and infection

242
Q

when are you most at risk after shunt placement?

A

up to 6 months

243
Q

what happens if infections persist with shunt?

A

Removal

244
Q

how long are you on antibiotics after shunt placement?

A

7-10 days

245
Q

after the shunt is removed what is placed?

A

a EVD that drains the CSF

246
Q

what is the care mangment for infant with a hydrocephalus/shunt?

A

monitor for increased ICP, measure head daily, palpate fontanels

247
Q

what is the nursing care for child with shunt/hydrocephalus

A

Monitor for changes in LOC, HA, sleep behaviors, developmental abilities

248
Q

what is the post op shunt care?

A

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
Q

what patient ed is given after shunt is placed?

A

teach fam, avoid contact sports, wear helmets, look into developmental programs, supprt

250
Q

what is Myelomeningocele aka?

A

Spina Bifida

251
Q

what does Myelomeningocele look like on the outside?

A

protrusion along spine that looks like a cyst

252
Q

what causes Myelomeningocele’

A

genes, syndromes, drugs, radiation, malnutritions, chemical exposure, diabetes, obestiy, FOLIC ACID

253
Q

what dieases is commonly found with Myelomeningocele

A

hydrocephalus

254
Q

what is the diagnostics for Myelomeningocele

A

mri, ultrasound, ct, pre natal

255
Q

what do serum tests during pregnancy look for in realtion to Myelomeningocele

A

elevated alpha theta protein

256
Q

what are the symptoms of Myelomeningocele

A

bump on lower back

257
Q

fetal surgery of Myelomeningocele

A

still in utero, prevents hydrocephalus, improves function, high risk

258
Q

when can operation take place on Myelomeningocele

A

24-72 hours after birth

259
Q

how soon must the operation for Myelomeningocele be done if it is leaking csf

A

24 hours

260
Q

what should you post op for Myelomeningocele surgery

A

prevent infection, cover site with sterile gauze, antibiotcs, prone, avoid POVIDONE IODINE

261
Q

why should you avoid povidone iodine on Myelomeningocele

A

neurotoxic

262
Q

what orthopneic consideration for Myelomeningocele surgery

A

begin with bed sore prevention and prevention deformities

263
Q

what genitourinary functions for Myelomeningocele surgery

A

preserve renal function and want older children to acheive continence

264
Q

how to prevent Myelomeningocele

A

folic acid

265
Q

what is the amount of folic acid you need per day

A

0.4 mg

266
Q

what temp route is contraindicated in Myelomeningocele

A

rectal

267
Q

where should babies be placed post Myelomeningocele surgery?

A

isolete

268
Q

how often to change dressing for Myelomeningocele surgery?

A

sterile dressing every 2-4 hours

269
Q

what posistion for babies post Myelomeningocele surgery?

A

prone

270
Q

what allergy are Myelomeningocele babies at risk for?

A

latex

271
Q

what age must you be to be diagnosed with a cognitive impairment?

A

less than 18

272
Q

can you be diagnosed with a cognitive above 18?

A

no

273
Q

what is sub average IQ in
intellectual disability?

A

75 or below

274
Q

what are areas of functional impairments?

A

communication, home life, community, leisure, health, safety, self care, social skills, academics, work, self direction

275
Q

what does communication mean in functional impairment?

A

how well do they interact with others

276
Q

what does home living mean in functional impairment?

A

how is their environmentq

277
Q

what does leisure mean in functional impairment?

A

what do they do for fun

278
Q

what are the factors contributing to cognitive impairment?

A

genetic, biochem, infection, family, social, environmental, organic,

278
Q

how are cognitive impairments diagnosed?

A

asq, standardized test, screenings, syndromes at birth

279
Q

what level of cognitive impairment can still go to school?

A

mild

280
Q

what education should be given to cognitive impairment people?

A

self care, positive enviornment, play, exercise, means of communication, discipline, socialization, planning for future

281
Q

what the best way to get cognitive impaired people to fix a behavior?

A

redirection

282
Q

whats the best way to communicate with cognitiveley impaired?

A

short, simple, concrete, using dolls, dont use figures of speech

283
Q

what is down syndrome called?

A

Trisomy 21

284
Q

what is risk of down syndrome after 35?

A

1 in 350

285
Q

what is the risk of down syndrome after 40?

A

1 in 100

286
Q

what are symptoms of downs?

A

square head, upward slant eye, flat nasal bridge, protroding tongue, epicanthal folds, excess skin around neck, short hands, stubby digits, hypotnia

287
Q

what is hypotnia

A

low muscle tone

288
Q

what are downs at risk for?

A

congenital heart defects, hypothyroidism, leukemia, resp tract infection

289
Q

what is the therapeutic management for downs?

A

surgery for congenital defects, hearing/vision assessment, thyroid test, life expectancy of 60

290
Q

when is down diagnosed?

A

usually at birth or during screening

291
Q

can a nurse inform the parent that their child has downs?

A

no

292
Q

what joint issue do downs have?

A

hyperextension

293
Q

what muscle issue are downs at risk for?

A

hypotonic

294
Q

why must downs be swaddled tight?

A

low muscle tone

295
Q

what nose problems do downs have?

A

underdevleoped nasal bone

296
Q

what does the underdeveloped nasal bone lead to in down/

A

stuffy nose, increased risk of resp infections, and trouble breathing when feeding

297
Q

what tongue issues do downs have?

A

protruding tongue that leads to difficutly feeding

298
Q
A
299
Q

why are downs at risk for constipation?

A

decreases muscle tone

300
Q

what are downs at risk for growth wise?

A

weight…obese

301
Q

what kind of soap for downs?

A

minimal soap and lotion

302
Q

is autism more common boys or girls?

A

boys

303
Q

what are symptoms of autism?

A

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
Q

what speaking problems milestones do autism kids have?

A

no babbling by 12, single words by 16 months, 2 words by 2 years

305
Q

what care management for autism?

A

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
Q

what are the three things that help with communication for autism?

A

short, simple, concrete

307
Q

what therapy is good for autism?

A

ST, OT,PT ABA

308
Q

what is aba therapy

A

applied behavior therapy….take them with you everywhere

309
Q

what family support for autism?

A

not their fault, treatment programs, care for their child at home, assist in long term placement when they get older

310
Q

what type of sports for autism?

A

one on one sports no teams

311
Q

what schools for autism

A

regular school unless deaf/blind

312
Q

what is done when csf is infected?

A

the external shunt is placed until the infection goes away

313
Q

what procedures can cause meningitis?

A

lumbar puncture and shunt

314
Q

what does meningitis do to ICP?

A

increases it

315
Q

what damage can occur due to meningitis?

A

hearing and learning disability

316
Q

acute symptomatic seizures

A

due to being caused by something that occurred recently……trauma, meningitis

317
Q

remote symptomatic seizure

A

nothing going on currently their is a trauma infection from past

318
Q

what is a cryptogenic seizure?

A

unknown cause

319
Q

what is a idiopathic seizure

A

genetic

320
Q

what is an atonic seizure?

A

cant move certain body parts

321
Q

do you dress spina bifida babies

A

no

322
Q

page 1000 for early signs of delay

A
323
Q

what type of temp regulation issues do downs have?

A

hypothermia

324
Q

what is myopia?

A

near sided where near objects are clear

325
Q

what is hyperopia

A

far sided objects are clear

326
Q

what is the treatment for myopia and hyperopia?

A

glasses

327
Q

what is amblyopia?

A

lazy eye blurred vision

328
Q

what is the treatment for amblyopia

A

eye patch

329
Q

what is strabismus?

A

cross eye

330
Q

what is the treatment for strabismus?

A

eye patch on strong eye

331
Q

what is the visually acuity test?

A

not when they cant talk helps find vision problems

332
Q

when is vision tests done?

A

at 5 and then yearly

333
Q

what is a penetrating eye injury?

A

when foreign object is in the eye

334
Q

what to do if child has penetrating eye injury?

A

fox shield to damaged eye and eye patch to good eye and ED

335
Q

what do you not do for a penetrating eye injury?

A

dont rub, dont remove object,

336
Q

what do you do for chemical eye injury?

A

irrigate for 20 minutes, go to ED, rest with eyes closed, dark room

337
Q

what do you do for non penetrating object?

A

dont rub, examine eye, remove object with wet gauze

338
Q

what are symptoms of hearing impairment in baby?

A

not looking when talked to, not answering name, not looking around with loud noise, weird talking

339
Q

when are hearing screens done?

A

24 hours after birth, before kindergarten, and yearly

340
Q

what not to do if rice and beans are in the ear

A

dont irrigate with water

341
Q

what is ottis media?

A

ear infection

342
Q

what are symptoms of ottis media?

A

hearing loss, fullness inside, pain, pulling at ear, fever, drainage, refusal to feed, crying when laying, change in behavior

343
Q

what part of ear is effected from ottis media?

A

inner ear

344
Q

what is commonly associated with ear infections?

A

sickness

345
Q

how are ear drops instilled into a child 3 and under?

A

pinnea back and down

346
Q

how are drops instilled into 4 and up?

A

pinnea back and up

347
Q

how is pain treated for ear infecion?

A

ibuprofen, lay on effected side, heat/cold pack

348
Q

what exposure should you avoid for ear infectino?

A

smoke

349
Q

how long can fever stay after starting antibiotics for ottis media?

A

48 hours

350
Q

how long will dr wait before prescribing antibiotics to ottis media

A

72

351
Q

what is a tymponoplasty?

A

tubes that are put behind the ear drug to help ear infection

352
Q

what is a myringotomy

A

cutting ear drum

353
Q

how long do tubes last in ears?

A

8-18 months

354
Q

what should you avoid getting in ears after tubss?

A

submerging in water

355
Q

whats normal after tubes are placed?

A

drainage that is cloudy, smelly

356
Q

what are the second line meds for seizures

A

fosphenytoin, phenytoin, phenobarbital

357
Q

what are the long term antiepileptics?

A

phenytoin, phenobarbital, levitiracetam

358
Q

how long are hypospdias patients have stent?

A

5-10 days

359
Q

how often do you take oxybutin

A

6-8 hours

PEDS Exam 3 (2 decks)

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