PEDIA Flashcards
what is the disorder that have pressure inside the cranium
INCREASE ICP
normal ICP
5-15 mmHg
what indicated if >15 ICP
increased ICP
what indicates if more than 20 ICP
life threatening
what disease in neurologic disorder that has cushing’s triad
Increase ICP
how do you determine the widen pulse pressure
Subtract Diastolic from Systolic
what is the shape of anterior
diamond
what are the 2 fontanels
anterior and posterior
what is the shape of posterior
triangular
Anterior fontanel closes at
12-18 months
posterior fontanel closes at
2-3 months
What aggravate fontanels
by crying
what is the early sign of ICP
High pitched Cry/Shrill Cry
early sign of ICP in the age of child
irritability and agitation
early sign of ICP in the age of adult
restlessness
early sign of ICP in the age of geria
confusion
Initial sign of increased ICP
headache
vomiting center of the body
Chemoreceptor Trigger Zone
what is anisocoria and what it represents
-uneven pupils
-represents f brain damage
what does dilated pupil indicates in increase ICP
shock
what does constricted pupil indicates in increase ICP
narcotic overdose
how do you indicate normal pupil
PERRLA
(pupil equally round and reactive to light and accommodation)
why does sunset eyes occur in ICP
the pressure of the brain is pushing downwards
position if you have ICP
semi fowlers
what does semi fowlers purpose in increase ICP
Drain CSF → decrease fluid → decrease pressure = Decrease ICP
what is avoided if you have increase ICP
coughing and sneezing
In ICP, limit fluid intake into ____
1,200-1,500 ml/day
what are the two diuretics in increase ICP
Lasix and mannitol
mannitol is what kind of diuretics
osmotic
Lasix is what kind of diuretics
loop
Lasix is localized or generalize
localized
mannitol is localized or generalize
generalized
Lasix and Mannitol is a potassium wasting diuretic. What do you need to monitor?
Monitor hypokalemia
Decadron (Dexamethasone) is ____
-steroid, anti inflammatory
-prevention of cerebral edema
Anticonvulsants is for
prevention of seizure episodes
In ICP, why are they acidic
Stress levels
Using Decadron → GI irritants
What are the two antacids
Mg Hydroxide and Aluminum hydroxide
side effect of Mg Hydroxide
Diarrhea (Mag tatae)
side effect of Aluminum hydroxide
Constipation (Ala tae)
what is the purpose of anti coagulants
to prevent complication of thrombosis
what are the two anti coagulants
heparin and warfarin
what are the medications contraindicated in increased ICP
opiates and sedatives
opiates and sedatives can occur
Severe cardiac/Respiratory depression
what do you call the type of seizure that is generalized (mula ulo hanggang paa)
Grand Mal Seizure
Mental clouding and intoxication seziure
Psychomotor Seizure
type of seizure that is absent, blank facial expression, automatisms, lip smacking
petit mal
Tonic clonic of a group of muscle → progresses to grand mal seizure
Jacksonian Seizure
type of seizure that is high temp and wide flactuations due to
febrile seizure
what is the most dangerous type of seizure
status epilepticus
what does occur in status epilepticus
30 mins → brain damage could occur (on and off)
what is the main management in seizure
medication
last resort management for seizure
surgery
what to WOF in phenytoin
gingival hyperplasia and pinking red urine
Benzodiazepines indication
Prevents seizure episodes
medication needed when you have Refractory Seizures
→ Iminostilbenes: Carbamazepine
why does Valproates: Valproic Acid is the last resort medication
due to hepatotoxicity
Valproates: Valproic Acid is not given to pregnant women due to _____
it will cause Neural tube defects
In children with bacterial meningitis, affect yung movement because
because meninges supports and nourishes the brain
in CSF analysis, why there is cloudy urine
because of elevate WBC, protein
Pathognomonic sign in bacterial meningitis
Kernig’s and Brudzinski sign
what is the difference between Kernig’s and Brudzinski sign
Kernig’s: (K)nee → Flex → Pain in the hamstring, back, neck = (+) Kernigs
Brudzinski: (B)atok → flex → pain the back and neck = (+)brudzinski
type of head trauma wherein there is Structural alteration brought by extravasation of blood
contusion
what is the important to emphasize in Antibiotic therapy
Finish Duration to prevent drug resistance
what should be the position in opisthotonos
side lying
type of head trauma wherein there is Jarring of the brain → sudden forceful contact in a rigid skull
concussion
what position in car if <3 y/o
rear facing
what position in car if >3 y/o
Front facing/ Forward facing booster seat
Most important prognostic indicator in head trauma
assessing LOC
what to do if there is (+) cervical injury
do not move the client → Immobilize
(-) cervical injury:
Height of the bed - 30 degrees to decrease ICP
Two way in the blood flow in the heart indicates
regurgitation
Point of Intersection of aorta and pulmonary artery
ductus arteriosus
if there is one problem in the heart
acyanotic
if there is two problem in the heart
cyanotic
why there is Machinery like murmur in PATENT DUCTUS ARTERIOSUS (PDA)
Nagbabanggaan ang tunog kasi naka bukas ung ductuss arteriosus
sign of cerebral hypoxia
irritability
DOC for PATENT DUCTUS ARTERIOSUS (PDA)
INDOMETHACIN
Indication of indomethacin
facilitates closure of PDA
secondary drug for PDA
ibuprofen
what happens in septal defect
→ Na bybypass ung lungs kasi may butas
signs and symptoms in septal defect
-Fatigue → poor feeding
-Dyspnea on exertion → activity intolerance
-Failure to thrive (delayed milestones)
-signs and symptoms of heart failure
In management, suture is use when ________
hole is small
if hole is big, what is the managemet
dacron patch
In dacron patch, the tissue is the ___
Decrease rejection rate and favorable
In dacron patch, the plastic is the ___
Increase rejection rate and use when tissue is fading
in COARCTATION OF AORTA, in upper extremities - the BP is
increase
in COARCTATION OF AORTA, in lower extremities - the BP is
decrease
in COARCTATION OF AORTA, in upper extremities - the pulse is
bounding
in COARCTATION OF AORTA, in lower extremities - the pulse is
weak sometimes absent
management in coarctation in aorta
Balloon Angioplasty with coronary stenting
is stent for lifetime
yes or no
YES
how may problems in tetralogy of fallot
4 problems
what is the primary problem in tetralogy of fallot
pulmonary stenosis
What allows mixing of blood in TOF
overriding of aorta
What is the compensatory mechanism in TOF?
Right ventricular hypertrophy
how does the patient with TOF keeps alive in VSD
narerelieve yung pressure kasi dahil may butas sa septum pumupunta ung blood sa left galing sa RV
kasi kung sarado, sa RV lang napupunta lahat
What keeps the patient alive in TOF
VSD
why does squatting is allowed in TOF
-Decrease venous return → decrease cardiac workload → promoting cardiac rest
-Conserve oxygen in the upper body
What is the pathognomonic sign in TOF
Tet spells
what can manifest in TET spells
-Group of s/sx that represents decrease oxygenation
-Irritability
-Convulsions
-Blackouts
-Pallor (hypoxemia)
diagnostic in TOF
2D ECHO
WHAT CAN SEEN IN 2D ECHO IN PATIENT WITH TOF
BOOT SHAPED HEART
TOF: WHAT IS THE SURGERY IN CURATIVE
INTRACARDIAC SURGERY/BROCKS PROCEDURE
TOF: WHAT IS THE PROCEDURE IN PALLIATIVE SURGERY AND HOW
Blalock Taussig Shunt
-Anastomosis (padudugtungin) of pulmonary artery and aorta using subclavian artery
TOF: WHAT IS THE GOAL IN PALLIATIVE SURGERY
Mas maraming oxygenated compared to unoxygenated
WHAT IS THE TWO SURGERY IN TOF
PALLIATIVE AND CURATIVE SURGERY
WHAT DOES BALLOON ANGIOPLASTY SOLVE IN TOF
PULMONARY STENOSIS
RIGHT VENTRICULAR HYPERTROPHY
WHAT DOES DACRON PATCH SOLVE IN TOF
REMOVAL OF VSD AND OVERRIDING OF AORTA
TOF: WHAT IS THE TWO PROCEDURE IN BROCKS
- BALLOON ANGIOPLASTY
- DACRON PATCH
ACYANOTIC vs. CYANOTIC
WHERE DOES THE MORE OXYGENATED BLOOD
ACYANOTIC
ACYANOTIC vs. CYANOTIC
WHERE DOES THE MORE UNOXYGENATED BLOOD
CYANOTIC
WHAT HAPPENS IN TOGA
Right Ventricle connected to aorta
Left Ventricle connected to pulmonary artery
WHAT MEDICATION CAN MAINTAINS AND KEEP THE PDA OPEN
PROSTAGLANDIN E
WHAT KEEPS THE PT ALIVE IN TOGA
PDA
ARTERIAL SWITCH/JATENE SURGERY IS DONE DURING __________
1ST WEEK OF LIFE
WHAT IS THE SURGERY IN TOGA
ARTERIAL SWITCH/JATENE SURGERY
WHAT IS THE LIFESPAN OF PDA INFANT
1-2 WEEKS
WHAT IS THE CAUSE IN RHEUMATIC HEART FEVER
BACTERIA
WHAT IS THE BACTER CALLED IN RHF
GABHS (Group A Beta Hemolytic Streptococcus)
WHAT ARE THE MAJOR CRITERIA IN JONES
JONES
J - Polyarthritis (Multiple joint inflammation)
O - carditis
N - Subcutaneous Nodules
E - Erythema Marginatum
S - Sydenham Chorea
WHAT TO CONSIDER IN JONES CRITERIA
2 Major + Hx of GABHS
1 major + 2 minor + Hx of GABHS
what is Sydenham chorea
(St. Vidus Dance - Worm like movement of fingers and arms)
where does Subcutaneous Nodules occur
Bony prominence (Knuckles, Knees, Elbow)
DOC FOR RHEUMATIC HEART FEVER
PENICILLIN
what is Erythema Marginatum
redness in trunk
WHAT ARE THE MINOR CRITERIA IN JONES
- Low grade fever
- Arthralgia - painful joints w/o swelling
- Elevation of ASO titers (Antistreptolysin O titer)
- Elevation of inflammatory markers (vague lab result kaya minor lang)
>ESR (erythrocyte sedimentation rate)
>CRP (C-reactive CHON)
IF ALLERGY TO PENICILLIN, WHAT YOU WILL GIVE
ERYTHROMYCIN
PENICILLIN IS GIVEN HOW MANY DAYS
5-10 DAYS
If there’s exacerbation and remission of RHF, THE ___________
Treatment is continued up to 10 years
MEDICATION USE IF THERE IS PAIN AND SWELLING IN RHEUMATIC HEART FEVER
SALICYLATES
WHAT TO MONITOR IF GIVING ASPIRIN
BLEEDING
WHAT MEDICATION USE THAT CAN RELIEVE CARDITIS IN RHEUMATIC HEART FEVER
CORTICOSTEROIDS
IF SYSTEMIC MANIFESTATIONS,
LSHF OR RSHF
RSHF
What aspirin use in RHF:
ANALGESIC AND ANTI INFLAMMATORY
IF PULMONARY MANIFESTATIONS,
LSHF OR RSHF
LSHF
Peripheral/Dependent/Pitting Edema
RSHF
Orthopnea
LSHF
Distended Neck Veins (JVD)
RSHF
Hepatomegaly
RSHF
Crackles, Rales
LSHF
LSHF OR RSHF: COUGH
LSHF
RSHF or LSHF: WEIGHT GAIN
RSHF
WHAT Measures the pressure in left side of the heart
Pulmonary Capillary Wedge Pressure (PCWP)
WHAT IS THE FORM OF COMPENSATION IN BOTH RSHF AND LSHF
TACHYCARDIA
R HF or L HF: BODY WEAKNESS, ANOREXIA, NAUSEA
RSHF
WHAT IS THE EARLY SIGN IN BOTH RSHF AND LSHF
TACHYCARDIA
IN HEART FAILURE, WHAT CAN BE SEEN IN CHEST XRAY
PRESENCE OF CARDIOMAEGALY
IN HEART FAILURE, WHAT CAN BE SEEN IN 2D ECHO
Hypokinetic heart
WHAT IS THE LATE SIGN IN HEART FAILURE
Hypokinetic heart
what measure the pressure in the right side of the heart
Central Venous Pressure (CVP)
normal Pulmonary Capillary Wedge Pressure (PCWP)
4-12 mmHg
what is the normal Central Venous Pressure (CVP)
12 mmHg
what is the position for heart failure
fowlers
what type of oxygen use in heart failure and why
venturi because its precise and accurate
what is the effect of inotropic drugs in heart failure
strengthens contraction → increases cardiac output
what indicates Lanoxin/Digoxin in heart failure
Maximize Cardiac Output
Signs of Digoxin Toxicity
N - nausea
A - anorexia
V - visual disturbances/vomiting
D - diarrhea
A - abdominal cramps
antidote for digoxin
digibind
What occurs in Kawasaki disease
-Mucocutaneous Lymph Nodes Syndrome (altered immune response)
-Multisystemic Vasculitis (inflammation of blood vessels)
Pathognomonic sign in Kawasaki disease
Strawberry Red Tongue
Signs and Symptoms in kawasaki disease
High Spiking Fever
Strawberry red tongue
Photophobia
Polymorphous rash
Palmar desquamation
what to remember in Palmar desquamation
KAWASAKI IS ONLY IN PALMAR NOT IN THE SKIN BC IF SKIN BUONG KATAWAN YON
WHAT CAN BE SEEN IN DIGNOSTIC IN KAWASAKI
ELEVATED ESR
diet for kawasaki
clear liquid diet
what antibodies given in kawasaki
immunoglobulins
what type of aspirin given in kawasaki
antipyretic
anti inflammatory
analgesic
cleft lip vs. cleft palate
tuwid mag salita
cleft lip
what to remember in clear liquid diet
clear liquid diet is considered if there’s opacity to light
cleft lip vs. cleft palate
have speech problem
cleft palate
why does cleft palate has the one with speech problem and not the cleft lip
because when we are talking, it is touching to the palate, so, if there’s clef
cleft lip is common in
lalaki
cleft palate is common in
females
why does large nipples is needed in cleft lip
to be easy to suck
what should be the cut of nipple if have child having cleft lip
Criss Cross cut of nipple
the one using Training cup, Medicine dropper
Cleft palate
surgery for cleft lip
cheiloplasty
surgery for cleft palate
Palatoplasty/ Palatorrhaphy
rule in cheiloplasty
rule of 10
10 wks
10 lbs
10k WBC
10g/dl hgb
in Palatoplasty/ Palatorrhaphy, why does it should not be too early
it will re open
in Palatoplasty/ Palatorrhaphy, why does it should not be too late
it will have speech problem
when should perform Palatoplasty/ Palatorrhaphy
18-24 months (this is when child starts to talk)
what is the post op position in Cheiloplasty
Turn on the unaffected side
if the patient has bilateral cleft lip, the POST OP position is _____
HOB ELEVATED
what is the post op position in Palatoplasty/ Palatorrhaphy and why
Prone - to drain secretions to prevent aspriation
MAIN PROBLEM IN GERD
Incompetent Lower Esophageal Sphincter (LES)
GERD IS ALSO KNOWN AS
CHALASIA
WHAT HAPPENS IF BARIUM SWALLOW IS MORE THAN 2 DAYS IN YOUR BODY
OBSTRUCTION
DIAGNOSTICS IN GERD
BARIUM SWALLOW
BARIUM SWALLOW LAST WITHIN
2 DAYS
OTHER TERM FOR Lower Esophageal Sphincter (LES)
CARDIAC SPHINCTER
WHAT TO DO IN ORDER TO EXCRETE THE BARIUM
Increase OFI laxatives as ordered
DIET FOR GERD
LOW FAT
HIGH PRIBER
FOODS TO AVOID IN GERD
SPICY FOODS
CAFFEINE
ALCOHOL
TOBACCO
WHAT IS THE MOST EFFECTIVE DRUGS IN GERD AND WHY
PPI
Because it blocks HCL production + protective covering to prevent further damage in linings
IN GERD, WHY DOES HIGH FIBER IS GIVEN
BECAUSE IT DECREASES PERISTALSIS
IN GERD, WHY DOES HIGH FAT IS AVOIDED
IT CAN CAUSE VOMIT
IN PYLORIC STENOSIS: PRESENCE OF WHAT IN ABDOMINAL
OLIVE SHAPED MASS
IN PYLORIC STENOSIS: IS THERE VOMITUS WITH BILE OR NON
WITHOUT BILE
IN PYLORIC STENOSIS: WHAT CAN HELP TO HASTEN DIGESTION
INCREASE OFI
WHAT DOES IT MEAN IF THERE’S BILE IN VOMITUS
THERE IS OBSTRUCTION
CELIAC DISEASE: REVERSIBLE OR IREVERSIBLE
IREVERSIBLE
CAUSE OF CELIAC DISEASE
MALABSORPTION OF GLUTEN
WHAT HAPPENS IN MALABSORPTION OF GLUTEN
The body can’t process gluten so it will remove the gluten through diarrhea
CONFIRMATORY DIAGNOSIS FOR CELIAC DISEASE
BOWEL BIOPSY
CELIAC DISEASE: foods allowed
Meat, Eggs, Milk products (milk, cheese, cream), all fruits and vegetables, rice, corn, corn flakes
CELIAC DISEASE: WHAT TO AVOID
BROW
barley
rye
oats
wheat
WHAT IS THE RESPONSIBLE OF GANGLIONIC
RESPONSIBLE FOR PERISTALSIS
HIRSCHSPRUNGS DISEASE: cause
AGANGLIONIC
PATHONOMONIC SIGN IN HIRSCHSPRUNGS DISEASE:
RIBBON LIKE STOOLS
HIRSCHSPRUNGS DISEASE: DIAGNOSTICS OF ENEMA, WHAT CAN BE SEEN
PRESENCE OF MEGACOLON
MAIN PROBLEM IN HIRSCHSPRUNGS DISEASE
FAILURE TO PASS MECONIUM FOR FIRST 24-48 HRS
HIRSCHSPRUNGS DISEASE: DIAGNOSTIC CONFIRMATORY TEST
RECTAL BIOPSY
SURGERY FOR HIRSCHSPRUNGS DISEASE:
SWENSON PULL THROUGH
NORMAL COLOR OF STOMA
PINKISH
BLUISH STOMA INDICATES
LACK CIRCULATION
Avoid foods that can obstruct the stoma
GAS FORMING FOODS
-CABBAGE, POTATO
FOODS ALLOWED IN HIRSCHSPRUNGS DISEASE
SPINACH
PARSLEY
YOGURT
BROCCOLI
WHAT DOES ABDOMEN LOOK LIKE IN INTUSSUSCEPTION
SAUSAGE SHAPE MASS
WHAT DOES STOOL LOOK LIKE IN INTUSSUSCEPTION
CURRANT JELLY LIKE STOOL (BLOODY MUCOID STOOL)
IN GUIAC TEST/OCCULT BLOOD TEST, DCF IS AVOID DUE TO
IT WILL BE FALSE POSITIVE
IN GUIAC TEST/OCCULT BLOOD, VIT C IS AVOIDED DUE TO
IT WILL BE FALSE NEGATIVE
IN GUIAC TEST/OCCULT BLOOD, WHAT IS THE AGENT USE
HYDROGEN PEROXIDE
IN USING HYDROGEN PEROXIFE, FORMATION OF BLUE RING INDICATES
BLEEDING
FUNCTIONS OF NGT
FIDME
Feeding
Irrigation
Decompression - decompress the abdominal distention
Medication
WHAT IS COUP DIESEASE
NARROWING OF AIRWAY DUE TO VIRAL INFLAMMATION
Pathognomonic sign IN CROUP
Barking seal like cough
IN CROUP, WHAT ARE SIGNS OF EPIGLOTITIS
Dooling
Nasal Flaring
Use of accessory muscles while breathing
IN CROUP, WHAT SHOULD BE THE ROOM TEMP AND WHY
COOL - INCREASE GAS EXCHANGE AND BRONCHODILATION
IN CROUP, WHAT SHOULD BE IN THE BEDSIDE AND WHY
TRACHEOSTOMY CARE - ANYTIME PWEDE MAG CLOSE AND AIRWAY
MEDS FOR CROUP
Antivirals: “vir” (main drug)
Antibiotics: Prophylaxis (preventing bacterial as well)
Bronchodilators: SE - TACHY
DISORDER THAT Blockage of exocrine glands (MUCUS)
CYSTIC FIBROSIS
IN CYSTIC FIBROSIS, WHAT IS SEEN IN SWEAT CHLORIDE TEST
INCREASE CHLORIDE LEVELS IN SWEAT
ORGANS AFFECTED IN CYSTIC FIBROSIS
PANCREAS, LUNGS, INTESTINES, SWEAT GLANDS
DIAGNOSTIC FOR CYSTIC FIBROSIS
SWEAT CHLORIDE TEST
process of removing mucus in the lungs
CHEST PHYSIOTHERAPY
IN CYSTIC FIBROSIS, AFTER POSTURAL DRAINAGE, WHAT WILL YOU TEACH PT
ORAL CARE
MEDS FOR CYSTIC FIBROSIS
pancreatic enzyme
NURSING CONSIDERATION IN PANCREATIC ENZYME
GIVEN W/ NO EMALS, NEVER DOUBLE THE DOSAGE
IS ASTHMA, REVERSIBLE OR IREVERSIBLE
REVERSIBLE
CAUSE OF ASTHMA
ALLERGENS
IN ASTHMA, WHEEZES IS HEARD IN ___
Expiratory
