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1
Q

osterogensis imperfecta aka

A

brittle bone

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2
Q

osterogensis imperfecta

A

impaired collagen causing bones to be frail and easily fractured

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3
Q

osterogensis imperfecta care

A

checking bp manually to avoid cuff overtightening

  • liftting the infant by slipping a hand under the broadest areas of the body (eg, back, buttocks) so the pressure is distributed
  • Repositioning the infant frequently using supportive devices and gel padding to avoid molding of the soft bones of the skull
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4
Q

esophageal atresia and tracheospghgeal fistula manestifatations

A
  • frothy salvia
  • choking
  • coughing
  • drooling
  • apnea and cyanosis when feeding
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5
Q

EA/TEF risks

A

apsirtation

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6
Q

EA/TEF interventions

A

maintaining NPO status, positioning the client supine, elevating the head at least 30 degrees, and keeping suction equipment by the bed to clear secretions from the mouth.

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7
Q

priority in EA/TEF

A

maintain clear airway and prevent aspiration

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8
Q

ea/tef contraindiacations

A

This client will likely require parenteral nutrition prior to surgery. A gastrostomy tube may be placed to allow for release of air and drainage of gastric contents to prevent aspiration; however, feedings or irrigations through the tube are contraindicated until after surgical correction of the TEF.
-NO FEEDINGS OF ANY KIND

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9
Q

pediculosis capitis

A

head lice

-often seen in school age

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10
Q

pediculosis capitis span

A

adult louse cannot survive away from the host’s head for >48 hours. However, the nits can live away from the host (eg, on hairbrushes, carpets, hats) for up to 10 days.
SO DONT SHARE

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11
Q

treatment of peduculossis capittis

A

peduuculicide to the head and removing nits with nit comb or by hand

  • use every 2-3 days for 2 weeks
  • clean carpets, rugs, fruniture
  • wash bedding in hot water and dried on the hottest dryer setting
  • non washable items must be sealed in plastic bad for 2 wk
  • all hairbrush, combs and ornaments should be soaked in boiling water for 10 mins or lice killing products for one hour
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12
Q

what doesnt transmit lice

A

household pets, pra; contact
utensils
-IT IS SPREAD DIRECT PERSON TO PERSON OR SHARING COMB PILLOW CLOTHING

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13
Q

juvenile idiopathic arthritis (JIA) minimize the risk

A

Both aerobic and anaerobic exercise can help minimize this risk, and resistance training can increase muscle strength and endurance.

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14
Q

what kind of excercises for JIA

A

l, low-impact, weight-bearing, and non-weight-bearing exercises that involve range of motion and stretching

  • VOID HIGH IMPACT
  • not reading book
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15
Q

hemophilia education

A

Avoid medications such as ibuprofen and aspirin

  • Avoid intramuscular injections; subcutaneous inj are preffered
  • Avoid contact sports and safety hazards; noncontact activities (eg, swimming, jogging, tennis) and use of protective equipment (eg, helmets, padding) are encouraged (Option 5).
  • -Dental hygiene is necessary to prevent gum bleeding, and soft toothbrushes should be used.
  • –MedicAlert bracelets should be worn at all times (Option 3).
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16
Q

what is not assoicated with hemophilia

A

malnutrtion

dehydration

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17
Q

dont use what in UTI

A

antibacterial soap bc it destorys natural flora

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18
Q

iron foods

A

meat
fish
poultry

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19
Q

vit c foods

A

potatoes
tomatoes
strawberries

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20
Q

what is poor source of iron

A

milkkkk prpducts

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21
Q

what interers with ironabsotption

A

calcium

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22
Q

leading cause of iron def in children

A

overconsumption of milk

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23
Q

vasoocculsive sicle cell crisis

A
  • -high painnnnn
  • -iv fluids
  • -bed rest to decrease energy expenditure and oxygen demand.
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24
Q

best avcivity for sickle cell

A

bed rest activity such as movies or book

NOT VIDEO GAMES, PAINTING, CHECKERS

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25
Q

mononucleosis is caused by

A

Epstein-Barr virus

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26
Q

mono spread by

A

sharing driks, kissing, direct exposure to salivia

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27
Q

symtoms of mono

A

fatigue, fever, sore throat, splenomegaly, hepatomegaly (VOID CONTACT SPORTS TO PREVENT INJURY TO SPLEEN OR LIVER), and swollen lymph nodes.

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28
Q

mono treatment

A

abx not effective bc it is virus
-treatment for mononucleosis is management of symptoms and includes hydration, rest (for fatigue), control of painIibuprhen nor tylenol NOT ASPRIN), and reducing fever as necessary. Sore throat is treated with saline gargles or anesthetic troches.

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29
Q

complications of mono

A

airway obstruction (eg, stridor, difficult breathing) from swollen lymph nodes around the neck and severe abdominal pain (splenic rupture).

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30
Q

pyrloric stenosis manesitifatations

A

olive-shaped mass may be palpated in the epigastric area just to the right of the umbilicus. –Emesis is nonbilious (formula in/formula out) and leads to progressive dehydration. –Infants will be hungry constantly despite regular feedings.

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31
Q

what abg is pyloric stenosis

A

met akalosis

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32
Q

pyrlpic stenosis leads to

A

dehydration
-IT IS NOT AN INFECTIOUS PROCESS SO WBC SHOULD NOT BE elevated
hypokalmeia
hemoconcentration (eelvated hct, and bun)

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33
Q

v shunt used to treat

A

hydrocepaylus

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34
Q

cushing triad

A

brady
slowed resp
widency pulse pressure

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35
Q

cshuntompliations of

A

blockage (with signs of increased intracranial pressure [ICP]) and infection

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36
Q

braducardia can be sign of

A

ICP

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37
Q

expected finding in cerebral palsy

A

spacisity /clonus

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38
Q

musuclar dystropy complation

A

resp and cardiac

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39
Q

fifth disease “slapped”

A

viral ilnnes by hpv
mainly in school age
-

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40
Q

fifth disease charactersitic

A

red rash on the cheeks that gives the appearance of having been slapped. The rash spreads to the extremities and a maculopapular rash develops, which then progresses from the proximal to distal surfaces.

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41
Q

fifth diases recover/ treatment

A

within 7-10 days.

-malaise and joint pain that are typically well controlled with nonsteroidal anti-inflammatory drugs such as ibuprofen.

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42
Q

fifth disase and inefectious period

A
  • Once these children develop symptoms (eg, rash, joint pains), they are no longer infectious.
  • Children with fifth disease are communicable only prior to onset of symptoms (eg, rash, joint pains).
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43
Q

fifth disease spread through

A

dropplet but isolation is not required

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44
Q

lead positing from

A

igestion
lead exposure
wall toys glazes (pottery)
-water from lead pipes, or by inhalation of contaminated dust or soil found around older homes.

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45
Q

elevated blood levels impair

A

neural, blood, and renal development.

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46
Q

blood lead screening test is recommended what age

A

between ages 1 and 2, or up to age 6 i

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47
Q

what lead level

A

Clients with elevated BLLs (≥5 mcg/dL [0.24 µmol/L]) require follow-up blood work to ensure that levels decrease

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48
Q

treatement for high lead levle

A

Chelation therapy

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49
Q

lead teaching

A

Pediatric and pregnant clients should not live in homes being renovated until the work is complete. —Handwashing, especially before eating, is important to remove lead residue

-Taps should be flushed for several minutes to clear out contaminated water before use.

Hard surfaces should be wet-dusted or mopped at least weekly. NOT VACC

= Hot tap water dissolves lead from older pipes; therefore, cold water should be used

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50
Q

Developmental dysplasia of the hip (DDH)

A

is instability/ dislocation of the hip joint that may be present at birth- the first few years of life. Nonsurgical treatment methods, such as a harness or cast, are most successful when initiated during the first 6 months of life. surgery is frequently required.

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51
Q

pavlik harness

A

most ocmmon tool to treat dysplasia

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52
Q

using palik harness how to

A

slightly flexed and abducted position

- worn for about 3-5 months

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53
Q

caring for pavik harness

A

Regularly assess skin for redness or breakdown under the straps

  • -Dress the child in a shirt and knee socks under the harness to protect the skin (Option 2)
  • -Avoid lotions and powders
  • -Lightly massage the skin under the straps every day to promote circulation (Option 3)
  • -Only apply 1 diaper at a time as wearing ≥2 diapers (previous treatment practice) increases risk of incorrect hip placement
  • -Apply diapers underneath the straps
54
Q

what is contridcated in immunosuppresion

A

live vacc

55
Q

FLACC and how to know if child in pain

A

Facial grimacing
Leg movement, tension, or bending up toward the chest
Activity, including squirming, arching, jerking
Crying or moaning
Difficulty consoling or comforting the child`

56
Q

Splenic sequestration crisis

A

occurs when a large number of “sickled” cells get trapped in the spleen, causing splenomegaly.
LIFE THEREANTING AND CAN LEAD TO HYPOVOLVEMIA(HYPOTENSIVE) SHOCK

57
Q

classic assessment of splenic sqeuestration cirsis

A

rapdily enlarging sleepn

58
Q

normal rbc lilves for and sick cell

A

120 days
-sickle cell reak apart and die within less than 20 days; therefore, the client always has a shortage of red blood cells (anemia). Due to anemia, clients often report feeling fatigued.

59
Q

complications of sickle

A

Right arm weakness could indicate new-onset stroke, a common complication of sickle cell disease that needs to be assessed. However, splenic sequestration is immediately life-threatening and a priority.

-) Swelling of hands and feet (dactylitis) is another symptom of this disease due to the sickled red blood cells blocking blood flow to the hands and feet.

60
Q

Splenic sequestration crisis signs

A

enlarging spleen and hypotension are the characteristic assessment findings.

61
Q

duchenne muscular dystrophy

A

x linked recessive

due to lack of a protein called dystrophin needed for muscle stabilizati

62
Q

The Gower sign .

A

involves the use of one’s hands to rise from a squat or from a chair to compensate for proximal muscle weakness

63
Q

Duchenne muscular dystrophy (DMD) treatment

A

no cure

- Most children are wheelchair bound by adolescence and die by age 20–30 from respiratory failure.

64
Q

duchenne muscular eduation

A

avoid floor clutter (eg, throw rugs) and prevent falls/injury

  • gentle recreation-based exercises and swimming to avoid disuse muscle atrophy and social isolation. –Overexertion such as weight lifting is not recommended due to the risk of muscle injury.
  • -Diet should be assessed to ensure adequate fluid, whole grains, fruits, and vegetables to maintain bowel function to reduce the risk for constipation from immobility.
65
Q

what is not related to duchenne muscular

A

iron def

66
Q

scarlet feve0 complication of r

A

group A atrep ( (eg, streptococcal pharyngitis),

67
Q

signs of scarlet

A

red rash. The rash begins on the neck and chest and spreads to the extremities, resembles a bad sunburn, blanches with pressure, and has fine bumps like sandpaper. Additional manifestations of streptococcal pharyngitis (eg, exudative pharyngitis, fever, swollen anterior cervical lymph nodes) are typically present.

68
Q

confiring scarlet fever

A
  • Because the clinical presentation (ie, rash plus sore throat) is characteristic, but not diagnostic, of scarlet fever, the health care provider will prescribe a rapid streptococcal antigen test to confirm symptom etiology
  • wabbing the posterior pharynx and tonsils provides test results within minutes. Throat culture may be necessary to verify results.
69
Q

treatment for scarlet

A

amoxillin

70
Q

eye sydnrome signs

A

cecepthapthy
cerebral edema
-asprin during influenzaor vericella infec
-fatty liver failure

71
Q

maestificatationsof reyes

A

ude fever, lethargy, acute encephalopathy, and altered hepatic function.

72
Q

expected lab finding reyes

A

Elevated serum ammonia lvl

73
Q

autism specttrum disorder oftene xhibit

A

sensory processing problems; they may be hyper- or hypo-sensitive to sounds, lights, movement, touch, taste, and smells.

74
Q

env for autism spectrum disorder

A

calming environment with minimal stimulation should be provided; a private room away from the nurses’ station is the best location.

75
Q

facilitate a calming environment for autism

A
  • Using a quiet or monotone voice when speaking to the child
    • Using eye contact and gestures carefully
  • Moving slowly
    • Limiting visual clutter
    • Maintaining minimal lighting
  • Providing the child with a single object to focus on
76
Q

Myelomeningocele area

A

risk for infection at this area. A priority nursing intervention is to cover the area with a sterile, moist dressing to decrease the risk of infection until surgical repair can occur.
-should be placed PRONE

77
Q

the amount of iron stored is dependent on the

A

length of gestation

78
Q

who at risk for less iron

A

preterm because less time in utero to accumulate iron

- Preterm infants typically deplete iron stores by age 2-3 months and require additional iron supplementation

79
Q

iron in a good term baby

A

sufficient iron stores for the first 4-6 months of life. However, infants receiving exclusively breastmilk require iron supplementation (eg, oral iron drops) around age 4 months until food sources of iron (eg, iron-fortified infant cereal) are adequate around age 6 months.

80
Q

menegtitis signs in infants and children less than 2

A

fever, restlessness, and a high-pitched cry.

81
Q

babinski sign

A

Babinski reflex can be present up to age 1-2 years and is a normal, expected finding; it does not indicate meningitis.

82
Q

what prpovides earlier assessment for ICP

A

Fontanel assessment (bulging tontanel and head circumf) provides an earlier indication of increased ICP.. cushing triad is a late sign (brady, resp dep, widened pulse pressure)

83
Q

pupil assemnt in mengitis

A

Because meningitis clients are sensitive to light (photophobia), frequent assessment of pupillary light response will be uncomfortable. Severely increased ICP may alter pupillary response; however, this is a late complication of hydrocephalus. Fontanel assessment provides an earlier indication of a developing problem.

84
Q

PKU

A

Individuals with PKU lack the enzyme (phenylalanine hydroxylase) required for converting the amino acid phenylalanine into the amino acid tyrosine. As unconverted phenylalanine accumulates, irreversible neurologic damage can occur.

85
Q

PKU management

A

low -phenylalanine diet
- Monitoring serum levels of phenylalanine
Including synthetic proteins and special formulas (eg, Lofenalac, Phenyl-Free) in the diet (Option 4)
Eliminating high-phenylalanine foods (eg, meats, eggs, milk) from the diet (Option 2)
Encouraging the consumption of natural foods low in phenylalanine (most fruits and vegetables)

86
Q

PKU normal level

A

2-6

87
Q

tinea copris aka

A

ringworm

88
Q

tinea coporis is a

A

fungal infection on the superficial keratin layers of the skin, hair, and/or nails.

89
Q

tinea copris is spread

A

highly contagious and spreads via contact ((eg, bathroom floors, gymnasium mats, car seats), personal items, or pets. )

90
Q

managment of tinea copis

A

hygiene (eg, washing hands after touching infected areas),

  • – limited contact with personal items (eg, hair brush),
  • – treatment with the prescribed shampoos as well as topical and/or oral medications (eg, terbinafine [Lamisil], miconazole).
91
Q

tinea copris treatment

A

Antifungal cream (terbinafine [Lamisil]) is the preferred treatment and is applied to infected areas twice a day. It may take 1-4 weeks to complete treatment depending on infection severity.

92
Q

who has highet risk of getting autism

A

genetic

so sibilings

93
Q

signs on ICP

A

bulging fontanelles, increasing head circumference, and sunset eyes (or setting-sun sign) (sclera visible above the iris).

94
Q

plagiocephaly (flat head syndrome)

A

when infent placed in same position (eg, supine) for an extended period of time and the pliable skull molds to the surface (flattens).

95
Q

normal amt of diapers in 24 hours

A

(6-10 diapers/day or approximately 1 diaper every 4 hours)

96
Q

putting child to sleep with bottle

A

dental caries - Bottles containing milk or sugary beverages should not be used as bedtime pacifiers.

97
Q

Developmental dysplasia of the hip (DDH risk factors

A

breech birth, large infant size, and family history.

98
Q

reducing risk of breech

A

Proper swaddling technique - infants should be swaddled with their hips bent up (flexion) and out (abduction), allowing room for hip movement (Option 3)

Choosing infant carriers or car seats with wide bases - infant seats should allow for proper hip positioning in an abducted manner

Avoiding any positioning device, seat, or carrier that causes hip extension with the knees straight and together
99
Q

precautions for mengitis

A

continued for 24 hours after initiation of antibiotic therapy.

100
Q

suspected meningits pt should be kept

A

NPOOOO
- allowing the client to self-position (Options 1 and 4). Due to nuchal rigidity, most clients prefer to lie with the head of the bed slightly raised and without a pillow, or in a side-lying position.

101
Q

fecal incontience means

A

repeated passage of stool in inappropriate places by children age ≥4 years.

102
Q

fecal incontience most of the time is due to

A

functional constipation

103
Q

mangemnt of fecal incontinnce/constipation 3 components

A

Disimpaction followed by prolonged laxative therapy, dietary changes (increased fiber and fluid intake), and behavior modification. Behavioral strategies are used to promote and restore regular toileting habits and to gain the child’s cooperation and participation in the treatment program.

104
Q

behavioral intevention for fecal incontinence

A
  • regularly schedule toilet sitting times 5-10 X mins after meals for 10-15 mins
  • Provide a quiet activity for the child during toilet sitting, which will help pass the time and make the experience more “enjoyable” (
  • Initiate a reward system to boost the child’s participation in the treatment program; the reward would be given for effort, NOT FOR SUCESS

–Keep a diary or log of toilet sitting times, stooling, medications, and episodes of soiling to evaluate the success of the treatment

105
Q

heart value injury

A

rheumatoid heart disease

106
Q

intelltual disbaility

A

fetal etoh , hypothryodism

lead poistioning

107
Q

cystic fibroris

A

recurrent pnuemonia

108
Q

joint destruction and joint bleeding

A

hemophilia

109
Q

febrile seziures

A

gernally benign
Parents should be instructed on appropriate cooling methods (eg, antipyretics, cool compresses), seizure safety precautions, and the avoidance of shivering.

110
Q

absence seizures last

A

less than 10 seconds and multiple can occur daily

111
Q

rotavirus transmission

A

contagious infection
fecal
transmission can occur through contact with food, toys, diapers, and hands.

112
Q

children with rotavirus are at risk for

A

dehydration

113
Q

rota virus is not treated

A

with abx bc it is viral

114
Q

pertussis

A

contangious

115
Q

smtoms of pertussis

A

c violent, spasmodic cough.
-Coughing episodes may continue until a thick mucus plug is expectorated and are sometimes followed by vomiting (posttussive emesis).
-

116
Q

treatment

A 
- antibiotics and supportive measures. 
 Humidified oxygen 
and adequate fluids 
-vaccination
-DONT GIVE COUGH SUPP
117
Q

airborne

A

measeals

varicella

118
Q

chicek pox most contgious

A

1-2 days before the rash and shorly after the rash (until all lesions are crusted over).

119
Q

water intoxication results in

A

hyponatremia
formula is too diluted causing hyponatremia or mother gives water
-the babies renal system is imature so it cant filter it the water out

120
Q

hyponatremia symtoms

A

irritability, lethargy, and, in severe cases, hypothermia and seizure activity.

121
Q

only sources of hydration the first 6 months

A

milk or formula

122
Q

physiologic anorxia meangement

A

Set and enforce a schedule for all meals and snacks
Offer the child 2 or 3 choices of food items
Do not force the child to eat
Keep food portions small
Expose the child repeatedly to new foods on several separate occasions
Avoid TV and games during meals or snacks

123
Q

physicologic anorixia

A

Physiologic anorexia occurs when the very high metabolic demands of infancy slow down to keep pace with the moderate growth of toddlerhood.
-during this phase toddlers are picky

124
Q

physilogic anroixia around what age

A

18 months

125
Q

acute diahrea and drhydration treamtent

A

first line is oral rehydration therpy

-continue the childs normal diet

126
Q

the brat diet

A

banana rie applysauce and toast is not recommended bc it doesnt have enough protein or energy

127
Q

use aof anitdiahreal in children

A

dont use

128
Q

EEG

A

Hair should be washed to remove oils and hair care products, and accessories such as ribbons or barrettes should be removed. Hair may need to be washed after the procedure to remove electrode gel.
Avoid caffeine, stimulants, and central nervous system depressants prior to the test.
The test is not painful, and no analgesia is required.

129
Q

how long are pavlik harness worn for

A

3-5 months or until hipi joint is stable

130
Q

ajusting the pavlik harness

A

parents shouldnt do it

-straps are assessed every 1-2 wk by HCP

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