mod 1 pediatrics Flashcards
1
Q
what stage of development are 0-1 year olds at
A
trust v mistrust
2
Q
autonomy v shame & guilt is experienced at what age
A
1-3yr
3
Q
what stage of development are at 3-6 yr
A
initiative v guilt
strong imagination, development of guilt/conscious
4
Q
what age is industry vs inferiority experienced at
A
6-12
5
Q
what stage of devlopment is 12-18 yr
A
identity v role confusion
heavy peer influence
6
Q
Piagets stage from birth to 2
A
sensorimotor (
7
Q
Piagets cognitive level for 2-7yrs
A
preoperational thought
magical thoughts
8
Q
what age according to piagets display concrete operations
A
7-11
9
Q
Piagets theory states that 11-15 yrs old showcase what in cognition
A
formal operations
carrying out ideas
knowledge of preception
10
Q
what is the role of play in development
A
teach what cannot be taught
sensorimotor development, self awareness, creativity, socialization, intellectual development
11
Q
play-onlooker is..
A
watching people play then join
12
Q
parallel play is..
A
play among others but not with
13
Q
associative play
A
play together, follow each other, control who play in group
14
Q
what is the most influecial factor for growth
A
nutrition
15
Q
what is cephalocaudal
A
measure from head to toe
16
Q
what is proximodistal
A
inward to outward pattern
17
Q
what is head circumference trying to measure
A
BRAINZ
18
Q
what is recumbent measurement
A
what the child is supine; used until child is able to stand alone
19
Q
height and stature are measure standing or laying
A
standing
20
Q
what is the Denver development screening done for
A
done for the suspicion of developmental delay
(social, fine motor, language, gross motor)
21
Q
gross motor come before fine motor, in what direction do they occur
A
cephalocaudal
22
Q
when does the anterior fontanelle close
A
12-18 months
23
Q
when does the posterior fontanelle close
A
1-3 months
24
Q
positional plagiocephaly
A
flat spot on back of head from no changing positions
25
when is cow milk recommended for children
4-6 months
26
how much sleep does a infant need
14-15 hours
27
Health promotion for infants
prevent aspiration, smoke detectors, no co-sleeping, safety gates. care seats (rear face, LATCH, seat belt)
28
immunization for infants
MMR, Varicella-> 1 years old
Heb B
29
nutrition for toddler s
limit juice to 4 oz, limit all sugary drink, physiologic anorexia (picky eaters)
30
injury prevention for toddler
food, choking hazard, burns, drowning, car seat
31
sleep required for toddler
11-12 hr
32
when should children be able to crawl, walk, toddle, run
crawl-9 mnth
stand- 1 year
toddle quickly- 13 month
run- 15 month
33
fine motor for 1, 2, 3
1- transfer objects from hand to hand
2- can hold crayon and color vertical, turn pages of book
3- copy circle and cross
34
fine motor for 4,5
4- use scissors, color within borders
5-can write letters and draw a person with body parts
35
what are bad signs or red flags for 9 months, 1 year, 15 months
9 month- unable to sit
1 year- transfer object from hand to hand
15 month- abnormal pincer grip or grasp
36
what are some red flags for 18 month, 2 years
18 months- not able to walk on own
2- unrecognizable speech
37
preschooler speech and developmental status
stuttering is normal, they become conscious, become aware of ugly and pretty, master BAITOR
38
what is the 5-2-1-0 nutrition framework
5 veg and fruit/day
2 hr or less of screen time/day
1hr phyical activity
0 sugar sweetened drink
39
what are some fine motor skills that a preschooler can show
buttoning clothes, holding crayon/pencil, building with blocks, using scissors, play board game
40
red flags for preschooler
can't self care that shit
lack of socialization
will they engage with others
can they follow simple direction
41
fine motor for school age
lego, sewing, instruments, painting, typing, reading, computer games, board games
42
red flags for school aged
lack of friends, school failure, social isolation, aggressive behavior (fighting, animal abuse, fire setting)
43
why do we discourage propping up a bottle
prevention of middle ear infection
44
final 20-25% of linear growth is finished during adolescents. T or F?
True
45
immunizations for adolescents
HPV, meningococcal
46
nutrition habits for adolescents
overeating, undereating, obesity
47
calcium deposits determines adolescents risk for osteoporosis so what do you recommend
increase calcium and vitamin D starting at age 13
48
injury prevention for adolescents
sexual healthy behavior, car safety, spf at least 15 for tanning
49
behavior problems for adolescents
depression, eating disorder (family inheritance), anger issue, suicide, attention deficit
50
what is the number one question for suicide assessment
do you have a plan
do you have access to gun/meds
51
what other psych stuff is associated with ADD, ADHD
oppositional disorder, anxiety, ticks
52
what should you teach adolescents
sexual/domestic abuse (they don't understand that it is not more than physical), relationships (what Is healthy), SUD, gang, driving, access to weapons, prolonged tech use, sexting, STI
53
describe petechiae
pinpoint, non blanching,( ITP, meningitis)
54
primary and secondary lesion
macule, papule, vesicle
55
macule vs papule
macule - flat
papule- pimple like
56
what are different dermatitis
contact, diaper, soberrhic, exema (atopic)
57
distribution pattern is described as
localized or generalized
58
what is the most common cause of contact dermatitis
hypersensitivity- plants, food, lotion, detergent, latex
59
diaper dermatitis is probably this when no creams or lotions work
candida ablicans - macularpapular erythematous rash with satellite lesions
60
what is management of diaper rash
breast milk, change diapers frequently, air that shit out, zinc oxide, vaseline, clostimazole, nystatin, avoid creams/lotion/detergents
61
drugs that end in -azole are usually to treat what
fungal infection
62
seborrheic dermatitis (cradle cap) lesions look like ...
thick, yellow, scaly, oily patches, maybe pruritic
63
what is called when cradle cap get on eye or ears
eyes- blepharitis
ears- otitis externa
64
what is management of seborrheic dermatitis
scalp hygiene, sulfur/salicylic acid containing shampoo, anti fungal shampoo
65
what makes seborrheic dermatitis worse
coconut oil, castor oil bc you are feeding it
66
eczema present on infant present where
cheeks scalp trunk EXTENSOR SURFACE OF EXTREMITY
67
childhood eczema present where
flexural areas (wrist ankles feet)
68
what is associated with eczema
allergy (allergy rhinitis), atopy
69
IgE is elevated in a pt with eczema. True or false
true
70
what is management of eczema
hydrate the skin, relieve inching, reduce flares (exposure to allergens), prevent/treat secondary infection, tepid baths, pat dry, while still moist apply aquafor, cetaphil, eucerin. oral antihistamines. topical steriods (intermittently), topical immunomodulators (nonsteriodal, tacrolimus, pimecrolimus best used at the beginning of dx HAVE TO BE 2 OR OLDER)
71
wha tis s/s for impetigo
reddish macule that becomes vesicular, easily ruptured before progressing to HONEY COLORED LESIONS, treated with topical antibiotic
72
bacterial skin infection
impetigo, cellulitis, follucitilitis
73
When are cellulitis pt hospitalized
around joints, face (eyes)
74
cellulitis is inflammation of the skin and sub q tissue with intense swelling, firm infiltration is treated with what
antibiotics
75
what causes folliculitis
pools, hot tub, shaving, tight fitting clothing. tx with TOPICAL antibiotic not oral
76
wart are what kind of infection
VIRAL no antibiotic needed (HPV)
77
what is management for warts
usually disappear on their own, cryotherapy, salicylic acid, laser, duct tape
78
molluscum contagious is what kind of infection that presents with flesh colored, dome shaped papule with central umbilication
viral cause by pox virus, resolves in about 18 months, cuts that thang off, cryotherapy
79
what is different type of herpes simplex
type 1- cold sore fever blister
type 2- GENTIALS
80
What is s/s of herpes simplex
grouped vesicles that itch and burn on inflammatory bases usually near mucus junctions
81
what is management of herpes simplex
burrow solution compress, acyclovir, valacyclovir, avoid secondary infection
82
what is s/s of herpes zoster
neuralgic pain, hyperesthisias, itching
83
what are fungal infection ON the skin
oral canadisis- thrush
tinea capitis- ringworm of scalp
tinea cruris- jock itch
tinea pedis- athletes foot
tinea corporis- on body
84
what is usually causes thrush
breast feeding, mom gets treated too, oral nystatin
85
griseofulvin is given for how long and with what food
over 4-6 week with high fat foods
86
terbinafine is taken over what do you monitor
2 weeks, liver function bc hepatotoxic
87
tinea capitus is contracted from what and what is tx
barber is suspected, selenium sulfide shampoo, terbinafine, griseofulvin
88
what is tx for tinea corporis, cruris, pedis
antifungals -azole, burrows compress of athletes foot for itchy NOT STEROIDS
89
education for pediculosis capitus (lice)
anyone can get it, no share combs brushes or hats, what linen in hot water, soak combs, brushes, in 1 hr or boiling hot water for 10 min
90
erythema migrans is a rash associated with what
Lyme disease (bullseye rash)
91
Tx for Lyme disease
doxycycline- >8 yrs old
amoxicillin or cefurixime <8 yr
92
scabies is tx with what
5% permethrin (everyone in the house needs to be treated), itching is worse at night
93
Tx for acne
NO SCRUBBING, retin A(avoid sun, extremely irritation, pea sized amount, after washing face wait 20-30 minute before application) benzoyl peroxide (antibacterial, bleaches linens) isotrentinoin (accutane, very teratogenic, two forms of contraception, for cystic acne, increases triglyceride ad cholesterol, depression, females need to be on contraception for a month after this medication), oral contraception
94
nursing care consideration for acne
support
encourage use of medication and skin care
encourage good eating
no picking or squeezing
education on hair products, makeup
95
what are the different burns
1st degree/superficial- damage minimal
2nd degree/partial thickness- partial thickness
3rd degree/full thickness
4th degree/ deep full thickness
96
minor burn management
remove clothing/jewlery, tepid water, no ice, cleanse with soap, antimicrobial ointment, monitor s/s infection, apply dressing, fine mesh, hydrocolloid
97
major burns health promotion
tetanus booster, maintiain airway and vent, increase cal and protein, initiate IV access NaCl or LR, topical agents bacitracin siladene, monitor UOP, manage pain (treat CO poisoning with 100% O2), ANTIBIOTICS ARE NO FIRST LINE, checking sugars, vitamin a and c and zinc for skin,
98
oxyhood is minimum what liters
4-5 L/min
99
when do you humidify NC o2 ?
4 or greater can go up to 5-6
100
in the event of a pediatric face mask what liters will It be at
short term 5-10L
101
who is o2 toxicity most likely to happen to
preterm babies
102
early signs of hypoxia
R- restless
A-anxiety
T-tachy
103
late signs of hypoxia
B- Brady
E- extreme restless
D- dyspnea
104
other sign that could indicate hypoxia
feeding difficulty, sternal retracting, inspiratory stridor, nasal flaring expiratory grunting
105
why does grunting occur in respiratory distress
they are creating a greater PEEP
106
at that age does viral infection run rampant
toddler preschool years, usually decreases after the age of 5
107
S/S of respiratory distress/illness
fever (101), anorexia, vomitting, diarrhea, nasal dc/blockage, sore throat, cough, adventitious lung sounds
108
when a younger child describes abdominal pain on the right side what respiratory issue is usually the suspect
right lower lobe pneumonia
109
what is the average length of nasopharyngitis (common cold)
10 days- OVC cough meds are NOT recommended, the cough will get worse as the days go on
110
at that age do you give decongestants
>6yr age
111
when do you educate the parents to bring their kiddo back or notify provider
fever greater the 4-5 days, respiratory distress, SOB
112
s/s and management of pharyngitis/tonsillitis
sore throat, HA, vomitting, fever, abd pain (school age), strawberry tongue
management- 10 day oral PCN, or IM if pt is +GABHS, pt is contagious for 24 hr after start of abs, throw toothbrush away
113
nursing intervention for post tonsillectomy, adenoidectomy
discourage coughing, avoid suctions, NO RED DRINK, expect blood tinged mucus, avoid milk ice cream pudding
call provider for throwing up blood, clearing throat/swallowing consistently
114
complications from Flu
severer viral pneumonia, secondary bacterial pneumonia (asthma), otitis media, sinusitis
115
what are the regulations for flu vax
annually >6
116
what medication is given for flu
Zanamivir >7
give tamiflu (oseltamivir) given within 48 hr (profuse vomitting, delirium, drunkenness) - given to pt at risk
117
what is the most common cause of otitis media
respiratory infection
117
s/s of otitis media
pulling in ear, fever, fussiness, purulent dc, hearing loss
118
when do you actually treat otitis media
less than 2 years of age, other than that wait and watch for 3 days
119
education for otitis media
Prevnar 7 vac, avoid cigs, no propped bottles
120
epiglottis is an emergency. T or F
TRUE
croup syndrom
medial emergency
121
epiglottis of mngt
ceftriaxone, steroids, emergency airway stuff, no tongue depressor, o2
122
s/s of epiglottis
cherry red epiglottis, no spontaneous cough, TRIPOD POSITION, 2-8 yr, drooling, muffled voice, painful swallowing
123
mngmt of mono
analgesics for throat discomfort, fluids, intense abd pain (enlarges spleen)
124
s/s of mono
HA, extreme fatigue, sore throat, cervical adenopathy, splenomegaly, palatine petechia (for up to two months)
125
laryngotracheobronchitis (croup) s/s
Barky, brassy cough, low grade fever, stridor (6 months-3 years), typical to follow URI
126
mgmt of croup
maintain patent airway, cool mist, racemic epi, dexamethasone (stridor)
127
Bronchitis is for what age group
teenage and adult (<6 yr)
bronchiolitis for children
128
s/s of bronchitis
cough that gets worse at night, can last 3 weeks
129
s/s of bronchiolitis
rhinorrhea, fever, conjunctivitis, poor feeding, irritable, wheezing, retractions
caused by rsv, adenovirus, parainfluenza
130
cystic fibrosis test
sweat Cl- test- ion imbalance (cl-)
131
cystic fibrosis s/s
abd distension, failure to poop, foul smelling big poop, wheezy respiration, failure to grow
132
what should people with hypopituitarism wear
medical bracelet
133
what other organic cause should we rule out before GH deficiency
NUTRITION, cystic fibrosis
it is definitively dx with blood
134
People with GH deficiency will get biosynthetic (somatotropin) growth hormone injections sub q. When should you give these
at night when GH is usually secreted. can get surgery if this is caused by lesions on brain
135
what is Normal to see is a GH deficit pt
overcrowded teeth, stunted growth (growth will not become normal pattern), x rays will reveal ossification
136
what is pituitary hyper function
excessive excretion of GH, usually very big (acromegaly) caused by a pituitary adenoma
137
s/s of Cushing
moon face, stria, temporal fat and red cheeks, poor wound healing, hyperglycemia, hypokalemia, high cortisol, 24 hr urine
138
what is precocious puberty
sexual developments before that age of 9 in boys, 7 yr in girls or 6yr
139
what intervention can be done in a pt receiving routine steroids and is experiencing Cushings
give steroids early am or alternating days
140
when is the highest incidence rate of DM
10-15 yr during DKA
141
