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4040 maternal child > mod 1 pediatrics > Flashcards

mod 1 pediatrics Flashcards

1
Q

what stage of development are 0-1 year olds at

A

trust v mistrust

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2
Q

autonomy v shame & guilt is experienced at what age

A

1-3yr

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3
Q

what stage of development are at 3-6 yr

A

initiative v guilt
strong imagination, development of guilt/conscious

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4
Q

what age is industry vs inferiority experienced at

A

6-12

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5
Q

what stage of devlopment is 12-18 yr

A

identity v role confusion
heavy peer influence

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6
Q

Piagets stage from birth to 2

A

sensorimotor (

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7
Q

Piagets cognitive level for 2-7yrs

A

preoperational thought
magical thoughts

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8
Q

what age according to piagets display concrete operations

A

7-11

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9
Q

Piagets theory states that 11-15 yrs old showcase what in cognition

A

formal operations
carrying out ideas
knowledge of preception

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10
Q

what is the role of play in development

A

teach what cannot be taught
sensorimotor development, self awareness, creativity, socialization, intellectual development

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11
Q

play-onlooker is..

A

watching people play then join

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12
Q

parallel play is..

A

play among others but not with

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13
Q

associative play

A

play together, follow each other, control who play in group

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14
Q

what is the most influecial factor for growth

A

nutrition

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15
Q

what is cephalocaudal

A

measure from head to toe

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16
Q

what is proximodistal

A

inward to outward pattern

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17
Q

what is head circumference trying to measure

A

BRAINZ

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18
Q

what is recumbent measurement

A

what the child is supine; used until child is able to stand alone

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19
Q

height and stature are measure standing or laying

A

standing

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20
Q

what is the Denver development screening done for

A

done for the suspicion of developmental delay
(social, fine motor, language, gross motor)

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21
Q

gross motor come before fine motor, in what direction do they occur

A

cephalocaudal

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22
Q

when does the anterior fontanelle close

A

12-18 months

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23
Q

when does the posterior fontanelle close

A

1-3 months

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24
Q

positional plagiocephaly

A

flat spot on back of head from no changing positions

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25
Q

when is cow milk recommended for children

A

4-6 months

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26
Q

how much sleep does a infant need

A

14-15 hours

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27
Q

Health promotion for infants

A

prevent aspiration, smoke detectors, no co-sleeping, safety gates. care seats (rear face, LATCH, seat belt)

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28
Q

immunization for infants

A

MMR, Varicella-> 1 years old

Heb B

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29
Q

nutrition for toddler s

A

limit juice to 4 oz, limit all sugary drink, physiologic anorexia (picky eaters)

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30
Q

injury prevention for toddler

A

food, choking hazard, burns, drowning, car seat

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31
Q

sleep required for toddler

A

11-12 hr

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32
Q

when should children be able to crawl, walk, toddle, run

A

crawl-9 mnth
stand- 1 year
toddle quickly- 13 month
run- 15 month

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33
Q

fine motor for 1, 2, 3

A

1- transfer objects from hand to hand
2- can hold crayon and color vertical, turn pages of book
3- copy circle and cross

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34
Q

fine motor for 4,5

A

4- use scissors, color within borders
5-can write letters and draw a person with body parts

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35
Q

what are bad signs or red flags for 9 months, 1 year, 15 months

A

9 month- unable to sit
1 year- transfer object from hand to hand
15 month- abnormal pincer grip or grasp

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36
Q

what are some red flags for 18 month, 2 years

A

18 months- not able to walk on own
2- unrecognizable speech

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37
Q

preschooler speech and developmental status

A

stuttering is normal, they become conscious, become aware of ugly and pretty, master BAITOR

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38
Q

what is the 5-2-1-0 nutrition framework

A

5 veg and fruit/day
2 hr or less of screen time/day
1hr phyical activity
0 sugar sweetened drink

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39
Q

what are some fine motor skills that a preschooler can show

A

buttoning clothes, holding crayon/pencil, building with blocks, using scissors, play board game

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40
Q

red flags for preschooler

A

can’t self care that shit
lack of socialization
will they engage with others
can they follow simple direction

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41
Q

fine motor for school age

A

lego, sewing, instruments, painting, typing, reading, computer games, board games

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42
Q

red flags for school aged

A

lack of friends, school failure, social isolation, aggressive behavior (fighting, animal abuse, fire setting)

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43
Q

why do we discourage propping up a bottle

A

prevention of middle ear infection

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44
Q

final 20-25% of linear growth is finished during adolescents. T or F?

A

True

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45
Q

immunizations for adolescents

A

HPV, meningococcal

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46
Q

nutrition habits for adolescents

A

overeating, undereating, obesity

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47
Q

calcium deposits determines adolescents risk for osteoporosis so what do you recommend

A

increase calcium and vitamin D starting at age 13

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48
Q

injury prevention for adolescents

A

sexual healthy behavior, car safety, spf at least 15 for tanning

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49
Q

behavior problems for adolescents

A

depression, eating disorder (family inheritance), anger issue, suicide, attention deficit

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50
Q

what is the number one question for suicide assessment

A

do you have a plan
do you have access to gun/meds

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51
Q

what other psych stuff is associated with ADD, ADHD

A

oppositional disorder, anxiety, ticks

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52
Q

what should you teach adolescents

A

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

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53
Q

describe petechiae

A

pinpoint, non blanching,( ITP, meningitis)

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54
Q

primary and secondary lesion

A

macule, papule, vesicle

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55
Q

macule vs papule

A

macule - flat
papule- pimple like

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56
Q

what are different dermatitis

A

contact, diaper, soberrhic, exema (atopic)

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57
Q

distribution pattern is described as

A

localized or generalized

58
Q

what is the most common cause of contact dermatitis

A

hypersensitivity- plants, food, lotion, detergent, latex

59
Q

diaper dermatitis is probably this when no creams or lotions work

A

candida ablicans - macularpapular erythematous rash with satellite lesions

60
Q

what is management of diaper rash

A

breast milk, change diapers frequently, air that shit out, zinc oxide, vaseline, clostimazole, nystatin, avoid creams/lotion/detergents

61
Q

drugs that end in -azole are usually to treat what

A

fungal infection

62
Q

seborrheic dermatitis (cradle cap) lesions look like …

A

thick, yellow, scaly, oily patches, maybe pruritic

63
Q

what is called when cradle cap get on eye or ears

A

eyes- blepharitis
ears- otitis externa

64
Q

what is management of seborrheic dermatitis

A

scalp hygiene, sulfur/salicylic acid containing shampoo, anti fungal shampoo

65
Q

what makes seborrheic dermatitis worse

A

coconut oil, castor oil bc you are feeding it

66
Q

eczema present on infant present where

A

cheeks scalp trunk EXTENSOR SURFACE OF EXTREMITY

67
Q

childhood eczema present where

A

flexural areas (wrist ankles feet)

68
Q

what is associated with eczema

A

allergy (allergy rhinitis), atopy

69
Q

IgE is elevated in a pt with eczema. True or false

A

true

70
Q

what is management of eczema

A

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
Q

wha tis s/s for impetigo

A

reddish macule that becomes vesicular, easily ruptured before progressing to HONEY COLORED LESIONS, treated with topical antibiotic

72
Q

bacterial skin infection

A

impetigo, cellulitis, follucitilitis

73
Q

When are cellulitis pt hospitalized

A

around joints, face (eyes)

74
Q

cellulitis is inflammation of the skin and sub q tissue with intense swelling, firm infiltration is treated with what

A

antibiotics

75
Q

what causes folliculitis

A

pools, hot tub, shaving, tight fitting clothing. tx with TOPICAL antibiotic not oral

76
Q

wart are what kind of infection

A

VIRAL no antibiotic needed (HPV)

77
Q

what is management for warts

A

usually disappear on their own, cryotherapy, salicylic acid, laser, duct tape

78
Q

molluscum contagious is what kind of infection that presents with flesh colored, dome shaped papule with central umbilication

A

viral cause by pox virus, resolves in about 18 months, cuts that thang off, cryotherapy

79
Q

what is different type of herpes simplex

A

type 1- cold sore fever blister
type 2- GENTIALS

80
Q

What is s/s of herpes simplex

A

grouped vesicles that itch and burn on inflammatory bases usually near mucus junctions

81
Q

what is management of herpes simplex

A

burrow solution compress, acyclovir, valacyclovir, avoid secondary infection

82
Q

what is s/s of herpes zoster

A

neuralgic pain, hyperesthisias, itching

83
Q

what are fungal infection ON the skin

A

oral canadisis- thrush
tinea capitis- ringworm of scalp
tinea cruris- jock itch
tinea pedis- athletes foot
tinea corporis- on body

84
Q

what is usually causes thrush

A

breast feeding, mom gets treated too, oral nystatin

85
Q

griseofulvin is given for how long and with what food

A

over 4-6 week with high fat foods

86
Q

terbinafine is taken over what do you monitor

A

2 weeks, liver function bc hepatotoxic

87
Q

tinea capitus is contracted from what and what is tx

A

barber is suspected, selenium sulfide shampoo, terbinafine, griseofulvin

88
Q

what is tx for tinea corporis, cruris, pedis

A

antifungals -azole, burrows compress of athletes foot for itchy NOT STEROIDS

89
Q

education for pediculosis capitus (lice)

A

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
Q

erythema migrans is a rash associated with what

A

Lyme disease (bullseye rash)

91
Q

Tx for Lyme disease

A

doxycycline- >8 yrs old
amoxicillin or cefurixime <8 yr

92
Q

scabies is tx with what

A

5% permethrin (everyone in the house needs to be treated), itching is worse at night

93
Q

Tx for acne

A

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
Q

nursing care consideration for acne

A

support
encourage use of medication and skin care
encourage good eating
no picking or squeezing
education on hair products, makeup

95
Q

what are the different burns

A

1st degree/superficial- damage minimal
2nd degree/partial thickness- partial thickness
3rd degree/full thickness
4th degree/ deep full thickness

96
Q

minor burn management

A

remove clothing/jewlery, tepid water, no ice, cleanse with soap, antimicrobial ointment, monitor s/s infection, apply dressing, fine mesh, hydrocolloid

97
Q

major burns health promotion

A

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
Q

oxyhood is minimum what liters

A

4-5 L/min

99
Q

when do you humidify NC o2 ?

A

4 or greater can go up to 5-6

100
Q

in the event of a pediatric face mask what liters will It be at

A

short term 5-10L

101
Q

who is o2 toxicity most likely to happen to

A

preterm babies

102
Q

early signs of hypoxia

A

R- restless
A-anxiety
T-tachy

103
Q

late signs of hypoxia

A

B- Brady
E- extreme restless
D- dyspnea

104
Q

other sign that could indicate hypoxia

A

feeding difficulty, sternal retracting, inspiratory stridor, nasal flaring expiratory grunting

105
Q

why does grunting occur in respiratory distress

A

they are creating a greater PEEP

106
Q

at that age does viral infection run rampant

A

toddler preschool years, usually decreases after the age of 5

107
Q

S/S of respiratory distress/illness

A

fever (101), anorexia, vomitting, diarrhea, nasal dc/blockage, sore throat, cough, adventitious lung sounds

108
Q

when a younger child describes abdominal pain on the right side what respiratory issue is usually the suspect

A

right lower lobe pneumonia

109
Q

what is the average length of nasopharyngitis (common cold)

A

10 days- OVC cough meds are NOT recommended, the cough will get worse as the days go on

110
Q

at that age do you give decongestants

A

> 6yr age

111
Q

when do you educate the parents to bring their kiddo back or notify provider

A

fever greater the 4-5 days, respiratory distress, SOB

112
Q

s/s and management of pharyngitis/tonsillitis

A

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
Q

nursing intervention for post tonsillectomy, adenoidectomy

A

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
Q

complications from Flu

A

severer viral pneumonia, secondary bacterial pneumonia (asthma), otitis media, sinusitis

115
Q

what are the regulations for flu vax

A

annually >6

116
Q

what medication is given for flu

A

Zanamivir >7
give tamiflu (oseltamivir) given within 48 hr (profuse vomitting, delirium, drunkenness) - given to pt at risk

117
Q

what is the most common cause of otitis media

A

respiratory infection

117
Q

s/s of otitis media

A

pulling in ear, fever, fussiness, purulent dc, hearing loss

118
Q

when do you actually treat otitis media

A

less than 2 years of age, other than that wait and watch for 3 days

119
Q

education for otitis media

A

Prevnar 7 vac, avoid cigs, no propped bottles

120
Q

epiglottis is an emergency. T or F

A

TRUE
croup syndrom
medial emergency

121
Q

epiglottis of mngt

A

ceftriaxone, steroids, emergency airway stuff, no tongue depressor, o2

122
Q

s/s of epiglottis

A

cherry red epiglottis, no spontaneous cough, TRIPOD POSITION, 2-8 yr, drooling, muffled voice, painful swallowing

123
Q

mngmt of mono

A

analgesics for throat discomfort, fluids, intense abd pain (enlarges spleen)

124
Q

s/s of mono

A

HA, extreme fatigue, sore throat, cervical adenopathy, splenomegaly, palatine petechia (for up to two months)

125
Q

laryngotracheobronchitis (croup) s/s

A

Barky, brassy cough, low grade fever, stridor (6 months-3 years), typical to follow URI

126
Q

mgmt of croup

A

maintain patent airway, cool mist, racemic epi, dexamethasone (stridor)

127
Q

Bronchitis is for what age group

A

teenage and adult (<6 yr)
bronchiolitis for children

128
Q

s/s of bronchitis

A

cough that gets worse at night, can last 3 weeks

129
Q

s/s of bronchiolitis

A

rhinorrhea, fever, conjunctivitis, poor feeding, irritable, wheezing, retractions

caused by rsv, adenovirus, parainfluenza

130
Q

cystic fibrosis test

A

sweat Cl- test- ion imbalance (cl-)

131
Q

cystic fibrosis s/s

A

abd distension, failure to poop, foul smelling big poop, wheezy respiration, failure to grow

132
Q

what should people with hypopituitarism wear

A

medical bracelet

133
Q

what other organic cause should we rule out before GH deficiency

A

NUTRITION, cystic fibrosis

it is definitively dx with blood

134
Q

People with GH deficiency will get biosynthetic (somatotropin) growth hormone injections sub q. When should you give these

A

at night when GH is usually secreted. can get surgery if this is caused by lesions on brain

135
Q

what is Normal to see is a GH deficit pt

A

overcrowded teeth, stunted growth (growth will not become normal pattern), x rays will reveal ossification

136
Q

what is pituitary hyper function

A

excessive excretion of GH, usually very big (acromegaly) caused by a pituitary adenoma

137
Q

s/s of Cushing

A

moon face, stria, temporal fat and red cheeks, poor wound healing, hyperglycemia, hypokalemia, high cortisol, 24 hr urine

138
Q

what is precocious puberty

A

sexual developments before that age of 9 in boys, 7 yr in girls or 6yr

139
Q

what intervention can be done in a pt receiving routine steroids and is experiencing Cushings

A

give steroids early am or alternating days

140
Q

when is the highest incidence rate of DM

A

10-15 yr during DKA

141
Q
A

4040 maternal child (6 decks)

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