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4040 maternal child > mod 3 peds > Flashcards

mod 3 peds Flashcards

i need a cig brother SOS

1
Q

maternal history that can be associated with heart dx in infant

A

DM, lupus, rubella, obesity

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2
Q

what does the inspection portion of the cardiac assessment include

A

respiratory rate and effort
cyanic, lethargic
poor weight gain (late sign)
edema
diaphoresis
clubbing of fingers (late sign)

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3
Q

does a child with down syndrome have a higher risk for cardiac disease

A

true; dont be so down

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4
Q

what does the palpation portion of cardiac assessment include

A

peripheral pulse
edema
cap refill
skin temp

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5
Q

pre-procedure checklist for a heart cath

A

assessment, hx, pulses, baseline o2, prepare child, NPO

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6
Q

post-procedure for a heart cath

A

pulse check, extremity (temp color), VS trend (EKG, BP), dressing, fluid intake, positioning, activity level

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7
Q

what are the two classifications of CHD

A

acyanotic, cyanotic

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8
Q

what classification is atrial septal defect

A

acyanotic

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9
Q

true or false? in a ventricle septal defect is can spontaneously close in <1yr

A

TRUE, also a acyanotic CHD

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10
Q

what is a atrioventricular Canal defect

A

both atrial and ventricle septal defect, and a valve insufficiency, low ASD, High VSD, LOUD murmur

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11
Q

what closes the ductus arterioles and foramen ovalale

A

the babies first breath

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12
Q

what is a sign of coarctation of the aorta

A

high BP in arm low BP in leg

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13
Q

how is aortic stenosis characterized

A

decreased CO, fainting, hypotensive, stop eating, stop playing,

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14
Q

what does the tetralogy of fallot include

A

VSD, pulmonic stenosis, right ventricular hypertrophy, overriding aorta

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15
Q

how is teratology of the fallot characterized

A

acute episodes of cyanosis (tet spells)

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16
Q

what characterizes truncus arteriousis

A

holosystolic murmur (prostaglandins given)

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17
Q

what is a hypo plastic left heart missing

A

left ventricle, closed mitral valve (prostaglandin given)

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18
Q

clinical symptoms of CHF

A

tachypnea, dyspnea, retractions, tacky at rest, activity intolerance

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19
Q

what is the goal of using digoxin

A

increase CO, decrease heart size, decrease venous pressure, relief edema, rapid onset short half life, nursing precaution, education

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20
Q

what is given for pediatric CHF

A

digoxin, ACE inhibitors, diretics

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21
Q

assessment of hypoxemia

A

polycythemia, clubbing (late sign), fatigue with feeding, poor weight gain, tachypnea/dyspnea, hyper cyanotic spells, neurologic complication (

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22
Q

what is the management of hypoxemia

A

prostaglandin
manage hyper cyanotic spells
hydration
prevent bacteria
pulmonary hygiene (IS, blowing bubbles)
appropriate activity level

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23
Q

how do you pick up a post op open heart baby

A

Scoop method- hand under head and butt/back

no picking up from under arms

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24
Q

what heart defect results in decrease pulmonary flow

A

tetralogy of fallot (not testable my ass)

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25
Q

what is the number one precaution for diuretics

A

K+ because of the risk of Dig toxicity

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26
Q

dig toxicity

A

vomitting, Brady, dysrhythmia, vision change, decreased urine, confusion

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27
Q

what does the neuro exam cover ?

A

LOC, Glasgow coma scale, pupil size, reactivity, reflexes, posturing

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28
Q

diagnostics for infective endocarditis

A

cbc, esr, cultures (x3 at different times), echo, UA (hematuria, proteinuria)

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29
Q

management of endocarditis

A

prophylactic abx for high risk pt (amox, ampicillin, clindimyocym if allergic to penicillin) IV abx at home (2-8 weeks), blood cultures

talk to the dentist about risk factors

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30
Q

rheumatic fever caused by what and how long is the latency

A

strep infection -> valve damage (most often the mitral valve)

2-6 weeks latency

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31
Q

diagnostics for rheumatic fever

A

jones criteria (two major or one major one minor), ASO titer, ESR, CRP

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32
Q

s/s of rheumatic fever

A

chorea (difficulty with fine motor skills, focusing and some dance goes away on its own), tachy, chest pain, polyrhythmic, new murmur, or change in preexisting murmur

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33
Q

management of rheumatic fever

A

PCN for 28 days
alternatives for PCN- erythromycin
salicylates (ASA 80-100g/kg/day)
Naproxen (20mg/kg/day)
prednisone

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34
Q

Kawasaki’s disease has three phases

A

acute- high fever that doesn’t respond to NSAIDs
convalescent phase- no s/s labs get better

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35
Q

s/s of Kawasaki

A

erythema of palms and soles, desquamation (peeling) of hands and feet, bilateral conjunctival injection, strawberry tongue, maculopapular rash, cervical lymphadenopathy, erythematous lips

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36
Q

management of Kawasaki

A

IV IG over 10-12 hours, ASA therapy for febrile 100mg/kg/day
ASA therapy when afebrile is 3-5 mg/kg/day

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37
Q

D/C teaching for Kawasaki

A

arthritis(temporary but do passive ROM), live immunizations(for 11 months), temp checks

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38
Q

nursing care for Kawasaki

A

monitor for signs of HF, s/e of IVIG (HA and nausea), skin care(cold compress, soft sheets), mouth care (, parental support

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39
Q

early signs of shock

A

tachy, decreased UOP, anxiety, impending doom, thirsty, good bp (LOW BP IS A LATE SIGN)

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40
Q

s/s of hypotensive phase of shock

A

narrow pulse pressure, sluggish cap refill, confusion, lethargy,

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41
Q

management of shock

A

o2, vent, fluids, blood transfusion, epi, dopamine

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42
Q

s/s of anemia

A

decreased PVR (not as many RBC), pallor, HA, fatigue, SOB, Pica

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43
Q

nursing care for anemia

A

diet, admin education( Vit C, usually increased Hbg in 1 month, do not give IM, avoid dairy products), cow milk (too much leads to this), safe storage

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44
Q

who are at higher risk for sickle cell anemia

A

AA, hispanics, Italian, greek, Iranian, Caribbean, asian Indian

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45
Q

management of sickle cell

A

rest, hydration, antbx, vaccines (pnomoccal, Flu, Hib) , o2, therapy, blood transfusion, pain med, hydroxyurea, HSCT

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45
Q

diagnostics for sickle cell

A

universal screening, sickledex, Hbg electrophoresis

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46
Q

what is the cure for sickle cell

A

HSCT

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47
Q

80% of cases of hemophilia are x linked. True or false?

A

TRUE

48
Q

what are factor IX deficiency

A

Hemophilia B, or Christmas disease

49
Q

What are the factor VIII deficiency

A

hemophilia A or classic hemophilia

50
Q

Von Willebrand disease is the absence of protein. True or False

A

TRUE

51
Q

clinical manifestation of sickle cells

A

1 obstruction of sickled RBC
2 vascular inflammation
3 increased RBC destruction

52
Q

exacerbation of sickle cells can be called

A

vascooculsive
sequestrian (pooling of blood in spleen or liver leads to shock)
aplastic
hyperhemolysis (jaundice, anemia, reticulocytosis)
Acute chest syndrome (PNA, fever, malaise, increase WBC, SOB, chest pain)
CVA

53
Q

management of hemophilia

A

factor VIII, DDAVP (only for classic hemophilia), avoid ASA, certain NSAIDs, corticosteroids for hematuria and chronic synovitis, avoid IM injection

54
Q

education of hemophilia

A

decreasing risk of injury, recognizing bleeding episodes, inform school nurse, osteoarthritis, cold pack ready to use

55
Q

characteristics of immune thrombocytopenia

A

thrombocytopenia, signs of bleeding, megakarocytes, and eosinophils

56
Q

what leads to immune thrombocytopenia

A

1-4 wks after viral illness

57
Q

Tx of immune thrombocytopenia

A

mainly supportive, IVIG, prednisone, anti-D antibody, splenectomy (Chronic, vaccine prior)

58
Q

what is the onset of intellectual disability

A

<18 years

59
Q

what are the functional impairments

A

communication, home living, self care, social skills, functional academics, work, self direction health and safety, leisure, community use

60
Q

signs of cognitive impairment

A

no response to contact, voice or movement
irritability
poor//slow feeding
poor eye contact during feeding
diminished spontaneous activity

61
Q

what can cause cognitive impairment

A

intrauterine infection/intoxicatio
trauma
matabolic or endocrine disorders
inadequate nutrition
postnatal brain disease
chromosomal anomalies
prematurity, low birth weight, post maturity
enviormental influence
unknown prenatal influence
psych disorders

62
Q

primary prevention of cognitive impairment

A

support preterm or high risk infant
rubella immunization
genetic counseling
maternal counseling (folic acid, alcohol, lead)

63
Q

nursing interventions for cognitive impairment

A

educate child and family
teach children self care
encourage play and exercise
establish discipline
encourage socialization
provide information on sexuality

64
Q

what are some physical charatericis of DS

A

protruding tongue, small nose with flat bridge, hypotonia (atlantoaxial instability)

65
Q

who passes fragile x syndrome

A

mom and dad

66
Q

fragile X syndrome physical manifestation

A

large head, long face, large ears, prognathism, hypotonic, large testes (macrorchidism)

67
Q

what are classic features of fragile x syndrome

A

mild to severe cognive impairment
delayed speech and language
hypersensitivity
autistic like behaviors
intolerance to routine change

68
Q

what meds are given to fragile x syndrome

A

fluoxetine, clonidine, melatonin

69
Q

management of fragile x syndrome

A

serotonin agents for havioral control
stimulants for hyperactivity
protein replacement and gene therapy options are being investigate
referral to an early intervention program

70
Q
A
71
Q
A
72
Q

what are causes for hearing impairment

A

low birth weight, ototoxic drugs (gent), chronic ear infection, perinatal asphyxia, perinatal infection, cerebral palsy, incubators, guns

72
Q

manifestation of hearing impairment

A

lack of startle reflex, not talking or making noise, indifference to sound, lack of response to spoken work

73
Q

what causes visual impairment

A

gonorrhea, clamidyia, rubella, syphillis, toxoplasmosis, retinopathy (high o2), trauma, conjunticitis

74
Q

is the MMR vax or vax with thimerosal linked to autism

A

Nah man that dude was full of shit

75
Q

what are some of the criteria with ASD

A

social interaction, communication, restricted repetitive, interest. activities, delays or abnormal functioning with onset before 3 tears

76
Q

what are lacerations in a head injury associated with

A

penetrating or depressed skull fractures

77
Q

s/s of bacterial meningitis

A

photophobia, poor feeding, vomitting, nuchal rigidity, positive kernig and brudzinski, petechial/ pupuric rashes

78
Q

manamgent of bacterial menegitis

A

cephalosporin, vanc, hydration, isolation, low stim

79
Q
A
80
Q
A
81
Q

what does the care of an unconscious child include

A

regular assessment of neuro, temp monitoring, LOC, pain management, respiratory, ICP monitoring

82
Q

s/s of concussion

A

confusion, HA, amnesia

83
Q

when does bone demineralization happen

A

when you don’t move around

83
Q

What happens to the metabolism due to immobility

A

decrease metabolic rate, negative nitrogen balance, hypercalcemia, decreased stress hormone

84
Q

effects of decreased mobility on the cardiovascular

A

decreased efficiency of orthostatic neuromuscular reflexes, diminished vasopressor

85
Q

effects of immobility on respiratory system

A

diminished vital compact, poor abdominal tone and distention, mechanical or biochemical secretion retention, loss of respiratory muscle strength

86
Q

what is a sprain

A

ligament is partially or completely torn, may have blood vessel damage, muscle, tendons and nerves

strain is a microscopic tear

87
Q

how long should ICE be used for

A

30 min at a time max

88
Q

buck is short term for things like contractors. T or F?

A

TRUE, WEIGHTS ARE HANGNING

89
Q

what are the 5 p’s of fracture

A

pain, pulse, pallor, parathesia, paralysis (pressure)

90
Q

What is done with hip dysplaisia

A

palivk harness for newborn to 6 months only, o

steps go over the diaper, parents do no move them

91
Q

what are the s.s for infant DDH

A

shortened limb (galeazzi), restricted abduction at hip, unequal gluteal folds, positive ortolani, Barlow test

92
Q

DDH in older children s.s

A

one leg is shorter, trendelenburg sign, lordosis, waddling gait

93
Q

what is the treatment of clubfoot (talipes Equinovarus)

A

seal casting, heel cord tenotomy, long leg cast

94
Q

s/s of egg-calve-perthes disease

A

AVASCULAR NECROSIS OF THE FEMORAL HEAD, limping , pain

management with rest, sx, traction,

95
Q

child around puberty age (8-15) \, and obese with limp, hip and groin, thigh or knee pain is what

A

slipped capital femoral epiphysis

96
Q

what is the treatment for slipped capital femoral epiphysis

A

sx, in stitu pinning

97
Q

hyperlordsis and kyphosis is common in infant and obesity

A

ye s

98
Q

what can cause osteomyolitis

A

GBS and other infection

99
Q

management of osteomyolytis

A

need a PICC line, ABx for 3-4 weeks, nafcillin, clinda, vanc

100
Q

JIA peak ages

A

1-3 yr, 8-10 yr before 16 yr with more then 1 joints for more then 6 weeks

101
Q

meds for JIA

A

methotrexate (no pregnant, no alcohol), sulfasalazine, etanercept, infliximab, glucocorticoids

102
Q

s.s of CP

A

delayed gross motor development, unilateral hand use, tongue thrust, abdominal posture, primitive relfex, ADHD symptoms

103
Q

s/s of encephalitis

A

HA, dizzy, nuchal rigidity, tremor, hyperactivity, high fever, spasticity

104
Q

tx of encephalitis

A

corticosteroids, plasma phersis, acyclovir (for only HSV caused),

105
Q

what is the diagnosis of rabies test

A

skin biopsy

106
Q

what is the rabies vx series days

A

1-7-14

immunoglobulin is given within the first 7 days of rabies contraction and after the receiving the vax

107
Q

what can lead to reye syndrome

A

influenza and varicella and giving ASA

108
Q

what has a hidden salicylate

A

PEPTO- you goin to get REYE Dumbass

109
Q

what labs are watched in Reye syndrome

A

clotting factor

110
Q

what is the diet recommended for seizures

A

key toe

111
Q

how long does a child have to stay in the hospital after a drowning injury

A

24 hr in the hospital

112
Q

what can cause hydrocephalus

A

TORCH

113
Q

s/s of hydrocephalus

A

dialed scalp veins, mace wan sign (cracked pot sounds), papilledema, sun setting irritable

114
Q
A
115
Q
A
116
Q
A

4040 maternal child (6 decks)

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